| Angiography-based C-arm CT for the assessment of extrahepatic shunting before radioembolization. | |
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MedLine Citation:
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PMID: 20183775 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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PURPOSE: To retrospectively assess the accuracy of angiography-based C-arm CT for the detection of extrahepatic shunting before SIRT. MATERIALS AND METHODS: 30 patients (mean age: 64+/-12 years) with hypervascularized hepatic tumors underwent hepatic angiography, coil embolization of gastrointestinal collaterals and 99mTc-macroaggregated albumin (MAA) SPECT/CT before SIRT. Before MAA injection via a microcatheter from the intended treatment position, an angiography and angiography-based C-arm CT (XperCT, Philips Healthcare) were acquired. Angiographies and XperCT were performed from 48 microcatheter positions followed by MAA injections and MAA-SPECT/CT. MAA-SPECT/CT served as the reference standard for determining the accuracy of hepatic arteriography and C-arm CT for the detection of extrahepatic shunting. RESULTS: MAA-SPECT/CT revealed extrahepatic shunting in 5 patients (17%). Hepatic arteriography yielded a true negative in 22 (73%), a false negative in 5 (17%), and an unclear result in 3 patients (10%). C-arm CT yielded a true positive in 3 (10%), true negative in 24 (80%), false positive in 1 (3%), and false negative in 2 patients (7%). The specificity and the NPV of hepatic arteriography for the detection of extrahepatic shunting were 88% and 81%, respectively. For C-arm CT the sensitivity, specificity, PPV, NPV, and accuracy for the detection of extrahepatic shunting were 60%, 96%, 75%, 92%, and 90%, respectively. CONCLUSION: C-arm CT offers additional information to angiography when assessing SIRT patients for extrahepatic shunting. More accurate detection of extrahepatic shunting may optimize the workflow in SIRT preparations by avoiding unnecessary repeat angiographies. |
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Authors:
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T A Heusner; M E Hamami; J Ertle; S Hahn; T Poeppel; P Hilgard; A Bockisch; M Forsting; G Antoch |
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Publication Detail:
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Type: Journal Article Date: 2010-02-24 |
Journal Detail:
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Title: R?Fo : Fortschritte auf dem Gebiete der R?ntgenstrahlen und der Nuklearmedizin Volume: 182 ISSN: 1438-9010 ISO Abbreviation: Rofo Publication Date: 2010 Jul |
Date Detail:
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Created Date: 2010-06-21 Completed Date: 2010-06-30 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 7507497 Medline TA: Rofo Country: Germany |
Other Details:
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Languages: eng Pagination: 603-8 Citation Subset: IM |
Copyright Information:
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Copyright (c) Georg Thieme Verlag KG Stuttgart-New York. |
Affiliation:
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Institut f?r Diagnostische und Interventionelle Radiologie und Neuroradiologie, Universit?tsklinik Essen, Essen. till.heusner@uni-due.de |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Aged, 80 and over Angiography, Digital Subtraction / instrumentation* Brachytherapy / instrumentation, methods Carcinoma, Hepatocellular / blood supply*, radiotherapy* Collateral Circulation / physiology Embolization, Therapeutic / instrumentation*, methods Female Gastrointestinal Tract / blood supply Humans Image Processing, Computer-Assisted* Liver Circulation / physiology Liver Neoplasms / blood supply*, radiotherapy*, secondary* Male Microspheres Middle Aged Regional Blood Flow / physiology Sensitivity and Specificity Technetium Tc 99m Aggregated Albumin / diagnostic use* Tomography, Emission-Computed, Single-Photon / instrumentation* Tomography, X-Ray Computed / instrumentation* Yttrium Radioisotopes / therapeutic use* |
| Chemical | |
Reg. No./Substance:
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0/Technetium Tc 99m Aggregated Albumin; 0/Yttrium Radioisotopes |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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