Olivier Pellerin1,2,3, Helena Pereira4,5, Claire Van Ngoc Ty6, Nadia Moussa6,7, Costantino Del Giudice8,6,7, Simon Pernot6,9, Carole Déan7, Gilles Chatellier6,4,5, Marc Sapoval8,6,7. 1. INSERM U970, Paris, France. Olivier.pellerin@aphp.fr. 2. Université Paris Descartes, Sorbonne Paris Cité, Paris, France. Olivier.pellerin@aphp.fr. 3. Department of Interventional Radiology, Hôpital Européen Georges Pompidou, Assistance Publique - Hôpitaux de Paris, 20 rue Leblanc, 75015, Paris, France. Olivier.pellerin@aphp.fr. 4. Clinical Research Unit, Hôpital Européen Georges Pompidou, Assistance Publique - Hôpitaux de Paris, Paris, France. 5. INSERM U1418, Paris, France. 6. Université Paris Descartes, Sorbonne Paris Cité, Paris, France. 7. Department of Interventional Radiology, Hôpital Européen Georges Pompidou, Assistance Publique - Hôpitaux de Paris, 20 rue Leblanc, 75015, Paris, France. 8. INSERM U970, Paris, France. 9. Department of Digestive Oncology, Hôpital Européen Georges Pompidou, Assistance Publique - Hôpitaux de Paris, Paris, France.
Abstract
PURPOSE: This study aimed to estimate the accuracy of dual-phase C-arm cone beam computed tomography (CBCT) for the detection of colorectal cancer liver metastases, as compared with multidetector computed tomography (MDCT). MATERIALS AND METHODS: Between March 2014 and December 2016, 49 consecutive patients referred for intra-arterial treatment for colorectal cancer liver metastases were enrolled in a single-center observational study. All patients were examined with MDCT and with dual-phase C-arm cone beam computed tomography performed after iodine injection in the proper hepatic artery before intra-arterial treatment. Two blinded observers independently reviewed all examinations. Diagnostic accuracy was determined using both a six-cell matrix method and a "worst-case scenario." RESULTS: Readers identified at MDCT 264 colorectal liver metastases and 43 other liver lesions. The early and late arterial phase showed 240 and 277 liver lesions respectively. A certainty of the diagnosis was obtained in 63% and 85% at the early (EAP) and late arterial phase (LAP), respectively. Streak artifacts or liver segment truncation, or inadequate enhancement was responsible for the inability to see or to correctly adjudicate a lesion to a diagnosis in 27% and 15% of the cases at the EAP and LAP. The "worst-case scenario" yielded a Se and Sp of 58% and 51%, respectively, at EAP and 84% and 70%, respectively, at LAP. CONCLUSION: On CBCT, EAP showed limited accuracy. LAP provided the best tumor detectability. KEY POINTS: • The early arterial phase (EAP) yielded poor accuracy: Se = 58% and Sp = 51% (p < 0.0001). • The late arterial phase (LAP) phase yielded good accuracy: Se = 84% and Se = 70% (p = 0.02). • The probability of a correct diagnosis at the EAP was 60%.
PURPOSE: This study aimed to estimate the accuracy of dual-phase C-arm cone beam computed tomography (CBCT) for the detection of colorectal cancer liver metastases, as compared with multidetector computed tomography (MDCT). MATERIALS AND METHODS: Between March 2014 and December 2016, 49 consecutive patients referred for intra-arterial treatment for colorectal cancer liver metastases were enrolled in a single-center observational study. All patients were examined with MDCT and with dual-phase C-arm cone beam computed tomography performed after iodine injection in the proper hepatic artery before intra-arterial treatment. Two blinded observers independently reviewed all examinations. Diagnostic accuracy was determined using both a six-cell matrix method and a "worst-case scenario." RESULTS: Readers identified at MDCT 264 colorectal liver metastases and 43 other liver lesions. The early and late arterial phase showed 240 and 277 liver lesions respectively. A certainty of the diagnosis was obtained in 63% and 85% at the early (EAP) and late arterial phase (LAP), respectively. Streak artifacts or liver segment truncation, or inadequate enhancement was responsible for the inability to see or to correctly adjudicate a lesion to a diagnosis in 27% and 15% of the cases at the EAP and LAP. The "worst-case scenario" yielded a Se and Sp of 58% and 51%, respectively, at EAP and 84% and 70%, respectively, at LAP. CONCLUSION: On CBCT, EAP showed limited accuracy. LAP provided the best tumor detectability. KEY POINTS: • The early arterial phase (EAP) yielded poor accuracy: Se = 58% and Sp = 51% (p < 0.0001). • The late arterial phase (LAP) phase yielded good accuracy: Se = 84% and Se = 70% (p = 0.02). • The probability of a correct diagnosis at the EAP was 60%.
Authors: Rüdiger E Schernthaner; Julius Chapiro; Sonia Sahu; Paul Withagen; Rafael Duran; Jae Ho Sohn; Alessandro Radaelli; Imramsjah Martin van der Bom; Jean-François H Geschwind; MingDe Lin Journal: Radiology Date: 2015-05-20 Impact factor: 11.105
Authors: Ruediger E Schernthaner; Reham R Haroun; Rafael Duran; Howard Lee; Sonia Sahu; Jae Ho Sohn; Julius Chapiro; Yan Zhao; Boris Gorodetski; Florian Fleckenstein; Susanne Smolka; Alessandro Radaelli; Imramsjah Martijn van der Bom; MingDe Lin; Jean Francois Geschwind Journal: Cardiovasc Intervent Radiol Date: 2016-07-05 Impact factor: 2.740