Jan B Hinrichs1,2, Julius Renne3, Marius M Hoeper4, Karen M Olsson4, Frank K Wacker3, Bernhard C Meyer3. 1. Department for Diagnostic and Interventional Radiology, Member of the German Center for Lung Research (DZL), Hannover Medical School, Hannover, Germany. hinrichs.jan@mh-hannover.de. 2. Hannover Medical School, Institute for Diagnostic and Interventional Radiology, Carl-Neuberg-Str. 1, 30625, Hannover, Germany. hinrichs.jan@mh-hannover.de. 3. Department for Diagnostic and Interventional Radiology, Member of the German Center for Lung Research (DZL), Hannover Medical School, Hannover, Germany. 4. Clinic for Pneumology, Member of the German Center for Lung Research (DZL), Hannover Medical School, Hannover, Germany.
Abstract
PURPOSE: To investigate the feasibility of and compare two C-Arm CT (CACT) guidance methods during balloon pulmonary angioplasty (BPA). MATERIAL AND METHODS: Forty-two BPAs [27 CTEPH patients (nine males, 70 ± 14y)] targeting 143 pulmonary arteries were included. Twenty-two BPAs were guided by contrast-enhanced CACT acquired immediately before BPA (G3D). In another 20 BPAs (G2D), two orthogonal fluoroscopy images of the chest where acquired to compute a registration of a previously acquired CACT. Volume rendering-based graphic representations (VRT guidance) were generated indicating the origin and course of the vessels. Based on VRT guidance, the intervention was planned. Procedure durations and radiation exposure data were compared between the two groups (Wilcoxon test). RESULTS: The overall intervention time was approximately 2 h in both groups (p = 0.31). BPA was successfully performed in G3D 91 % and G2D 94 %. No significant difference was found concerning the mean dose area product (DAP) related to fluoroscopy (p = 0.38), while DAP related to DSA was slightly higher in G3D (p = 0.048). Overall, DAP was significantly higher in G3D (p = 0.002). CONCLUSIONS: The use of CACT for procedure guidance in patients undergoing BPA is feasible and accurate. Image fusion of a pre-acquired CACT can be used to decrease radiation exposure due to multiple BPA sessions. KEY POINTS: • BPA guidance by CACT overlay is feasible and safe. • 2D3D image fusion for BPA guidance is accurate. • Image fusion can reduce patient radiation dose due to repeated BPA sessions.
PURPOSE: To investigate the feasibility of and compare two C-Arm CT (CACT) guidance methods during balloon pulmonary angioplasty (BPA). MATERIAL AND METHODS: Forty-two BPAs [27 CTEPH patients (nine males, 70 ± 14y)] targeting 143 pulmonary arteries were included. Twenty-two BPAs were guided by contrast-enhanced CACT acquired immediately before BPA (G3D). In another 20 BPAs (G2D), two orthogonal fluoroscopy images of the chest where acquired to compute a registration of a previously acquired CACT. Volume rendering-based graphic representations (VRT guidance) were generated indicating the origin and course of the vessels. Based on VRT guidance, the intervention was planned. Procedure durations and radiation exposure data were compared between the two groups (Wilcoxon test). RESULTS: The overall intervention time was approximately 2 h in both groups (p = 0.31). BPA was successfully performed in G3D 91 % and G2D 94 %. No significant difference was found concerning the mean dose area product (DAP) related to fluoroscopy (p = 0.38), while DAP related to DSA was slightly higher in G3D (p = 0.048). Overall, DAP was significantly higher in G3D (p = 0.002). CONCLUSIONS: The use of CACT for procedure guidance in patients undergoing BPA is feasible and accurate. Image fusion of a pre-acquired CACT can be used to decrease radiation exposure due to multiple BPA sessions. KEY POINTS: • BPA guidance by CACT overlay is feasible and safe. • 2D3D image fusion for BPA guidance is accurate. • Image fusion can reduce patient radiation dose due to repeated BPA sessions.
Authors: Alexander A Schegerer; Ursula Lechel; Manuel Ritter; Gerald Weisser; Christian Fink; Gunnar Brix Journal: Invest Radiol Date: 2014-10 Impact factor: 6.016
Authors: Christian Schoenfeld; Jan B Hinrichs; Karen M Olsson; Martin-Alexander Kuettner; Julius Renne; Till Kaireit; Christoph Czerner; Frank Wacker; Marius M Hoeper; Bernhard C Meyer; Jens Vogel-Claussen Journal: Eur Radiol Date: 2018-10-11 Impact factor: 5.315
Authors: Sabine K Maschke; Julius Renne; Thomas Werncke; Karen M Olsson; Marius M Hoeper; Frank K Wacker; Bernhard C Meyer; Jan B Hinrichs Journal: Eur Radiol Date: 2017-03-30 Impact factor: 5.315
Authors: Sabine K Maschke; Jan B Hinrichs; Julius Renne; Thomas Werncke; Hinrich M B Winther; Kristina I Ringe; Karen M Olsson; Marius M Hoeper; Frank K Wacker; Bernhard C Meyer Journal: Eur Radiol Date: 2018-09-12 Impact factor: 5.315
Authors: Christoph B Wiedenroth; Karen M Olsson; Stefan Guth; Andreas Breithecker; Moritz Haas; Jan-Christopher Kamp; Jan Fuge; Jan B Hinrichs; Fritz Roller; Christian W Hamm; Eckhard Mayer; Hossein A Ghofrani; Bernhard C Meyer; Christoph Liebetrau Journal: Pulm Circ Date: 2017-12-28 Impact factor: 3.017
Authors: Timo C Meine; Cornelia L A Dewald; L S Becker; Aline Mähringer-Kunz; Benjamin Massoumy; Sabine K Maschke; Martha M Kirstein; Thomas Werncke; Frank K Wacker; Bernhard C Meyer; Jan B Hinrichs Journal: Abdom Radiol (NY) Date: 2020-11
Authors: Lena S Becker; Marcel Gutberlet; Sabine K Maschke; Thomas Werncke; Cornelia L A Dewald; Christian von Falck; Arndt Vogel; Roman Kloeckner; Bernhard C Meyer; Frank Wacker; Jan B Hinrichs Journal: Cardiovasc Intervent Radiol Date: 2020-12-06 Impact factor: 2.740
Authors: Bernhard C Meyer; Jan B Hinrichs; Lena S Becker; Cornelia L A Dewald; Christian von Falck; Thomas Werncke; Sabine K Maschke; Roman Kloeckner; Frank K Wacker Journal: Cancer Imaging Date: 2022-07-30 Impact factor: 5.605