Cornelia L A Dewald1, Timo C Meine1, Hinrich M B Winther1, Roman Kloeckner2, Sabine K Maschke1, Martha M Kirstein3, Arndt Vogel3, Frank K Wacker1, Bernhard C Meyer1, Julius Renne1, Jan B Hinrichs4. 1. Department of Diagnostic and Interventional Radiology, Member of the German Center for Lung Research (DZL), Institute for Diagnostic and Interventional Radiology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany. 2. Department of Diagnostic and Interventional Radiology, Johannes Gutenberg-University Medical Centre, Mainz, Germany. 3. Department of Gastroenterology, Hepatology and Endocrinology, Hannover Medical School, Hannover, Germany. 4. Department of Diagnostic and Interventional Radiology, Member of the German Center for Lung Research (DZL), Institute for Diagnostic and Interventional Radiology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany. hinrichs.jan@mh-hannover.de.
Abstract
PURPOSE: To evaluate the feasibility of 2D-perfusion angiography (2D-PA) for detecting leakage of the double-balloon catheter used for chemosaturation percutaneous hepatic perfusion (CS-PHP). MATERIALS AND METHODS: Overall, 112 CS-PHP (09/2015-09/2018) in 52 patients were retrospectively screened for leakage alongside the double-balloon catheter on standard venograms. Finally, 18 procedures with visually detected leakage were included. Fifteen consecutive procedures without leakage served as control. To evaluate 2D-PA for leakage detection, the acquired digital subtraction venograms were post-processed. For each balloon, two different target ROIs were evaluated to assess a possible impact of localization and shape of the ROIs. Time to peak (TTP), peak density (PD), area under the curve (AUC), and ratios of target ROI/reference ROIs (PDtROI/PDREF; AUCtROI/AUCREF; and TTPtROI/TTPREF) were calculated. RESULTS: Leakages were located as follows: 15/18 cranial and 3/18 caudal. At the cranial balloon both ROIs showed a significant decrease in PDtROI/PDREF and AUCtROI/AUCREF (ROI1: p < 0.0001; p < 0.0001; ROI2: p < 0.0001; p < 0.0001) and a significant increase in TTPtROI/TTPREF (ROI1: p = 0.0009; ROI2: p = 0.0003) after double-balloon correction. Following balloon adjustment, the 2D-PA ratios (PD and AUC) of the tested ROIs differed significantly (p < 0.05). The inter-individual comparison of the 2D-PA parameters of the group with leakage before balloon correction and the non-leakage group showed significantly different 2D-PA values for the cranial balloon in both ROIs (p < 0.05). No significant differences were found for the caudal balloon. CONCLUSION: 2D-PA provides a feasible tool for detecting leakages alongside the cranial portion of the double-balloon catheter used in CS-PHP. The shape and position of the ROIs used to assess perfusion and flow have an impact on the measurements.
PURPOSE: To evaluate the feasibility of 2D-perfusion angiography (2D-PA) for detecting leakage of the double-balloon catheter used for chemosaturation percutaneous hepatic perfusion (CS-PHP). MATERIALS AND METHODS: Overall, 112 CS-PHP (09/2015-09/2018) in 52 patients were retrospectively screened for leakage alongside the double-balloon catheter on standard venograms. Finally, 18 procedures with visually detected leakage were included. Fifteen consecutive procedures without leakage served as control. To evaluate 2D-PA for leakage detection, the acquired digital subtraction venograms were post-processed. For each balloon, two different target ROIs were evaluated to assess a possible impact of localization and shape of the ROIs. Time to peak (TTP), peak density (PD), area under the curve (AUC), and ratios of target ROI/reference ROIs (PDtROI/PDREF; AUCtROI/AUCREF; and TTPtROI/TTPREF) were calculated. RESULTS: Leakages were located as follows: 15/18 cranial and 3/18 caudal. At the cranial balloon both ROIs showed a significant decrease in PDtROI/PDREF and AUCtROI/AUCREF (ROI1: p < 0.0001; p < 0.0001; ROI2: p < 0.0001; p < 0.0001) and a significant increase in TTPtROI/TTPREF (ROI1: p = 0.0009; ROI2: p = 0.0003) after double-balloon correction. Following balloon adjustment, the 2D-PA ratios (PD and AUC) of the tested ROIs differed significantly (p < 0.05). The inter-individual comparison of the 2D-PA parameters of the group with leakage before balloon correction and the non-leakage group showed significantly different 2D-PA values for the cranial balloon in both ROIs (p < 0.05). No significant differences were found for the caudal balloon. CONCLUSION:2D-PA provides a feasible tool for detecting leakages alongside the cranial portion of the double-balloon catheter used in CS-PHP. The shape and position of the ROIs used to assess perfusion and flow have an impact on the measurements.
Authors: C L A Dewald; L S Becker; S K Maschke; T C Meine; T A Alten; M M Kirstein; A Vogel; F K Wacker; B C Meyer; J B Hinrichs Journal: Clin Exp Metastasis Date: 2020-10-09 Impact factor: 5.150
Authors: Lena S Becker; Klaus Stahl; Timo C Meine; Christian von Falck; Bernhard C Meyer; Cornelia L A Dewald; Nina Rittgerodt; Markus Busch; Sascha David; Frank Wacker; Jan B Hinrichs Journal: Abdom Radiol (NY) Date: 2020-10
Authors: Cornelia L A Dewald; Lena S Becker; Sabine K Maschke; Timo C Meine; Bernhard C Meyer; Frank K Wacker; Jan B Hinrichs Journal: Cardiovasc Intervent Radiol Date: 2020-12-16 Impact factor: 2.740
Authors: Cornelia L A Dewald; Mia-Maria Warnke; Roland Brüning; Martin A Schneider; Peter Wohlmuth; Jan B Hinrichs; Anna Saborowski; Arndt Vogel; Frank K Wacker Journal: Cancers (Basel) Date: 2021-12-27 Impact factor: 6.639
Authors: Sebastian Ebel; Martin Reinhardt; Anne Bettina Beeskow; Felix Teske; Manuel Florian Struck; Rhea Veelken; Florian van Boemmel; Thomas Berg; Michael Moche; Matthias Gutberlet; Holger Gößmann; Timm Denecke Journal: BMC Med Imaging Date: 2022-09-13 Impact factor: 2.795