PURPOSE: To prepare for yttrium-90 ((90)Y) microsphere radioembolization therapy, digital subtraction angiography (DSA) and technetium- 99m-labeled macroaggregated albumin ((99m)Tc MAA) scintigraphy are used for treatment planning and detection of potential nontarget embolization. The present study was performed to determine if cone-beam computed tomography (CBCT) affects treatment planning as an adjunct to these conventional imaging modalities. MATERIALS AND METHODS: From March 2007 to August 2008, 42 consecutive patients (21 men, 21 women; mean age, 59 years; range, 21-75 y) who underwent radioembolization were evaluated by CBCT in addition to DSA and (99m)Tc MAA scintigraphy during treatment planning, and their records were retrospectively reviewed. The contrast-enhanced territories shown by CBCT with selective intraarterial contrast agent administration were used to predict intrahepatic and possible extrahepatic distribution of microspheres. RESULTS: In 22 of 42 cases (52%), extrahepatic enhancement or incomplete tumor perfusion seen on CBCT affected the treatment plan. In 14 patients (33%), the findings were evident exclusively on CBCT and not detected by DSA. When comparing CBCT versus (99m)Tc MAA scintigraphy, CBCT showed eight cases of extrahepatic enhancement (19%) that were not evident on (99m)Tc MAA imaging. CBCT findings directed the additional embolization of vessels or repositioning of the catheter for better contrast agent and microsphere distribution. One case of gastric ulcer from nontarget embolization caused by reader error was observed. CONCLUSIONS: CBCT can provide additional information about tumor and tissue perfusion not currently detectable by DSA or (99m)Tc MAA imaging, which should optimize (90)Y microsphere delivery and reduce nontarget embolization.
PURPOSE: To prepare for yttrium-90 ((90)Y) microsphere radioembolization therapy, digital subtraction angiography (DSA) and technetium- 99m-labeled macroaggregated albumin ((99m)Tc MAA) scintigraphy are used for treatment planning and detection of potential nontarget embolization. The present study was performed to determine if cone-beam computed tomography (CBCT) affects treatment planning as an adjunct to these conventional imaging modalities. MATERIALS AND METHODS: From March 2007 to August 2008, 42 consecutive patients (21 men, 21 women; mean age, 59 years; range, 21-75 y) who underwent radioembolization were evaluated by CBCT in addition to DSA and (99m)Tc MAA scintigraphy during treatment planning, and their records were retrospectively reviewed. The contrast-enhanced territories shown by CBCT with selective intraarterial contrast agent administration were used to predict intrahepatic and possible extrahepatic distribution of microspheres. RESULTS: In 22 of 42 cases (52%), extrahepatic enhancement or incomplete tumor perfusion seen on CBCT affected the treatment plan. In 14 patients (33%), the findings were evident exclusively on CBCT and not detected by DSA. When comparing CBCT versus (99m)Tc MAA scintigraphy, CBCT showed eight cases of extrahepatic enhancement (19%) that were not evident on (99m)Tc MAA imaging. CBCT findings directed the additional embolization of vessels or repositioning of the catheter for better contrast agent and microsphere distribution. One case of gastric ulcer from nontarget embolization caused by reader error was observed. CONCLUSIONS: CBCT can provide additional information about tumor and tissue perfusion not currently detectable by DSA or (99m)Tc MAA imaging, which should optimize (90)Y microsphere delivery and reduce nontarget embolization.
Authors: Dan Xia; Yu-Bing Chang; Joe Manak; Adnan H Siddiqui; Zheng Zhang; Buxin Chen; Emil Y Sidky; Xiaochuan Pan Journal: Sens Imaging Date: 2018-03-23
Authors: Riad Salem; Robert J Lewandowski; Vanessa L Gates; Charles W Nutting; Ravi Murthy; Steven C Rose; Michael C Soulen; Jean-Francois H Geschwind; Laura Kulik; Yun Hwan Kim; Carlo Spreafico; Marco Maccauro; Lourens Bester; Daniel B Brown; Robert K W Ryu; Daniel Y Sze; William S Rilling; Kent T Sato; Bruno Sangro; Jose Ignacio Bilbao; Tobias F Jakobs; Samer Ezziddin; Suyash Kulkarni; Aniruddha Kulkarni; David M Liu; David Valenti; Philip Hilgard; Gerald Antoch; Stefan P Muller; Hamad Alsuhaibani; Mary F Mulcahy; Marta Burrel; Maria Isabel Real; Stewart Spies; Abdulredha A Esmail; Jean-Luc Raoul; Etienne Garin; Mathew S Johnson; Al B Benson; Ricky A Sharma; Harpreet Wasan; Bieke Lambert; Khairuddin Memon; Andrew S Kennedy; Ahsun Riaz Journal: J Vasc Interv Radiol Date: 2011-03 Impact factor: 3.464
Authors: Dan Xia; David A Langan; Stephen B Solomon; Zheng Zhang; Buxin Chen; Hao Lai; Emil Y Sidky; Xiaochuan Pan Journal: Phys Med Biol Date: 2016-10-03 Impact factor: 3.609