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The Usefulness of Three-Dimensional Angiography with a Flat Panel Detector of Direct Conversion Type in a Transcatheter Arterial Chemoembolization Procedure for Hepatocellular Carcinoma: Initial Experience

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Abstract

The purpose of this study was to assess the usefulness of a three-dimensional (3D) angiography system using a flat panel detector of direct conversion type in treatments with subsegmental transcatheter arterial chemoembolization (TACE) for hepatocellular carcinomas (HCCs). Thirty-six consecutive patients who underwent hepatic angiography were prospectively examined. First, two radiologists evaluated the degree of visualization of the peripheral branches of the hepatic arteries on 3D digital subtraction angiography (DSA). Then the radiologists evaluated the visualization of tumor staining and feeding arteries in 25 patients (30 HCCs) who underwent subsegmental TACE. The two radiologists who performed the TACE assessed whether the additional information provided by 3D DSA was useful for treatments. In 34 (94.4%) of 36 patients, the subsegmental branches of the hepatic arteries were sufficiently visualized. The feeding arteries of HCCs were sufficiently visualized in 28 (93%) of 30 HCCs, whereas tumor stains were sufficiently visualized in 18 (60%). Maximum intensity projection images were significantly superior to volume recording images for visualization of the tumor staining and feeding arteries of HCCs. In 27 (90%) of 30 HCCs, 3D DSA provided additional useful information for subsegmental TACE. The high-quality 3D DSA with flat panel detector angiography system provided a precise vascular road map, which was useful for performing subsegmental TACE .of HCCs.

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References

  1. Zamann SN, Johnson PJ, Williams R (1990) Silent cirrhosis in patients with hepatocellular carcinoma. Cancer 65:1607–1610

    Article  Google Scholar 

  2. Yuen MF, Chan AO, Wong BC, et al. (2003) Transarterial chemoembolization for inoperable, early stage hepatocellular carcinoma in patients with Child-Pugh grade A and B: results of a comparative study in 96 Chinese patients. Am J Gastroenterol 98:1181–1185

    PubMed  Google Scholar 

  3. O’Suilleabhain CB, Poon RT, Yong JL, Ooi GC, Tso WK, Fan ST (2003) Factors predictive of 5-year survival after transarterial chemoembolization for inoperable hepatocellular carcinoma. Br J Surg 90:325–331

    Article  PubMed  CAS  Google Scholar 

  4. Matsui O, Kadoya M, Yoshikawa J, et al. (1993) Small hepatocellular carcinoma: treatment with subsegmental transcatheter arterial embolization. Radiology 188:79–83

    PubMed  CAS  Google Scholar 

  5. Itsubo M, Koike K, Tsuno S, et al. (2002) Subsegmental transcatheter arterial embolization for small hepatocellular carcinoma. Hepatogastroenterology 49:735–739

    PubMed  Google Scholar 

  6. Anxionnat R, Bracard S, Ducrocq X, et al. (2001) Intracranial aneurysms: clinical value of 3D digital subtraction angiography in the therapeutic decision and endovascular treatment. Radiology 218:799–808

    PubMed  CAS  Google Scholar 

  7. Tanoue S, Kiyosue H, Kenai H, Nakamura T, Yamashita M, Mori H (2000) Three-dimensional reconstructed images after rotational angiography in the evaluation of intracranial aneurysm: surgical correlation. Neurosurgery 47:866–871

    Article  PubMed  CAS  Google Scholar 

  8. Hirai T, Korogi Y, Suginohara K, et al. (2003) Clinical usefulness of unsubtracted 3D digital angiography compared with rotational digital angiography in the pretreatment evaluation of intracranial aneurysms. Am J Neuroradiol 24:1067–1074

    PubMed  Google Scholar 

  9. Tanigawa N, Komemushi A, Kojima H, Kariya S, Sawada S (2004) Three-dimensional angiography using rotational digital subtraction angiography: usefulness in transarterial embolization of hepatic tumors. Acta Radiol 45:602–607

    Article  PubMed  CAS  Google Scholar 

  10. Liapi E, Hong K, Georgiades CS, Geschwind JF (2005) Three-dimensional rotational angiography: introduction of an adjunctive tool for successful transarterial chemoembolization. J Vasc Interv Radiol 16:1241–1245

    PubMed  Google Scholar 

  11. Tanikake M, Shimizu T, Narabayashi I, et al. (2003) Three-dimensional CT angiography of the hepatic artery: use of multi-detector row helical CT and a contrast agent. Radiology 227:883–889

    Article  PubMed  Google Scholar 

  12. Rowlands JA, Hunter DM, Araj N (1991) X-ray imaging using amorphous selenium: a photoinduced discharge readout method for digital mammography. Med Phys 18:421–431

    Article  PubMed  CAS  Google Scholar 

  13. Chotas HG, Dobbins JT, Rabin CE (1999) Principles of digital radiography with large-area, electronically readable detectors: a review of the basics. Radiology 210:595–599

    PubMed  CAS  Google Scholar 

  14. Zhao W, Ji WG, Debrie A, Rowlands JA (2003) Imaging performance of amorphous selenium based flat-panel detectors for digital mammography: characterization of a small area prototype detector. Med Phys 30:254–263

    Article  PubMed  CAS  Google Scholar 

  15. Tsukamoto A, Yamada S, Tomisaki T, et al. (1999) Development and evaluation of a large-area selenium-based flat panel detector for real-time radiography and fluoroscopy. Proc SPIE 3659:14–23

    Article  Google Scholar 

  16. Woodard PK, Slone RM, Gierada DS, Reiker GG, Pilgram TK, Jost RG. (1997) Chest radiography: depiction of normal anatomy and pathologic structures with selenium-based digital radiography versus conventional screen-film radiography. Radiology 203:197–201

    PubMed  CAS  Google Scholar 

  17. Woodard PK, Slone RM, Sagel SS, et al. (1998) Detection of CT-proved pulmonary nodules: comparison of selenium-based digital and conventional screen-film chest radiographs. Radiology 209:705–709

    PubMed  CAS  Google Scholar 

  18. Neitzel U, Maack I, Günther-Kohfahl S (1994) Image quality of a digital chest radiography system based on a selenium detector. Med Phys 21:509–516

    Article  PubMed  CAS  Google Scholar 

  19. Kim TS, Im JG, Goo JM, et al. (2002) Detection of pulmonary edema in pigs: storage phosphor versus amorphous selenium-based flat-panel-detector radiography. Radiology 223:695–701

    Article  PubMed  Google Scholar 

  20. Adachi S, Hori N, Sato K, et al. (2000) Experimental evaluation of a-Se and CdTe flat-panel x-ray detectors for digital radiography and fluoroscopy. Proc SPIE 3977:38–47

    Article  CAS  Google Scholar 

  21. Jang HJ, Lim JH, Lee SJ, Park CK, Park HS, Do YS (2000) Hepatocellular carcinoma: are combined CT during arterial portography and CT hepatic arteriography in addition to triple-phase helical CT all necessary for preoperative evaluation? Radiology 215:373–380

    PubMed  CAS  Google Scholar 

  22. Peterson MS, Baron RL, Dodd GD III, et al. (1992) Hepatic parenchymal perfusion defects detected with CTAP: imaging-pathologic correlation. Radiology 185:149–155

    PubMed  CAS  Google Scholar 

  23. Oliver III JH, Baron RL, Dodd III GD, Peterson MS, Carr BI (1995) Does advanced cirrhosis with portosystemic shunting affect the value of CT arterial portography in the evaluation of the liver? AJR 164:333–337

    PubMed  Google Scholar 

  24. Hidajat N, Wust P, Felix R, Schroder RJ (2006) Radiation exposure to patient and staff in hepatic chemoembolization: risk estimation of cancer and deterministic effects. Cardiovasc Interv Radiol 29:791–796

    Article  Google Scholar 

  25. Hatakeyama Y, Kakeda S, Korogi Y, et al. (2006) Intracranial 2D and 3D DSA with flat panel detector of the direct conversion type: initial experience. Eur Radiol 16:2594–2602

    Article  PubMed  Google Scholar 

  26. Johnson PT, Heath DG, Kuszyk BS, Fishman EK (1996) CT angiography with volume rendering: advantages and applications in splanchnic vascular imaging. Radiology 200:564–568

    PubMed  CAS  Google Scholar 

  27. Sugahara T, Korogi Y, Nakashima K, Hamatake S, Honda S, Takahashi M (2002) Comparison of 2D and 3D digital subtraction angiography in evaluation of intracranial aneurysms. Am J Neuroradiol 23:1545–1552

    PubMed  Google Scholar 

  28. Lee SS, Kim TK, Byun JH, et al. (2003) Hepatic arteries in potential donors for living related liver transplantation: evaluation with multi-detector row CT angiography. Radiology 227:391–399

    Article  PubMed  Google Scholar 

  29. Granfors PR, Aufrichtig R (2000) Performance of a 41 × 41-cm2 amorphous silicon flat panel x-ray detector for radiographic imaging applications. Med Phys 27:1324–1331

    Article  PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Department of Radiology, University of Occupational and Environmental Health School of Medicine, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu, 807-8555, Japan

    Shingo Kakeda, Yukunori Korogi, Yoshihisa Hatakeyama, Norihiro Ohnari & Nobuhiro Oda

  2. Technology Research Laboratory, SIMAZU Co., Sohraku-gun, Kyoto, 619-0237, Japan

    Kazuyoshi Nishino & Wataru Miyamoto

Authors
  1. Shingo Kakeda
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  2. Yukunori Korogi
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  3. Yoshihisa Hatakeyama
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  4. Norihiro Ohnari
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  5. Nobuhiro Oda
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  6. Kazuyoshi Nishino
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  7. Wataru Miyamoto
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Correspondence to Shingo Kakeda.

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Kakeda, S., Korogi, Y., Hatakeyama, Y. et al. The Usefulness of Three-Dimensional Angiography with a Flat Panel Detector of Direct Conversion Type in a Transcatheter Arterial Chemoembolization Procedure for Hepatocellular Carcinoma: Initial Experience. Cardiovasc Intervent Radiol 31, 281–288 (2008). https://doi.org/10.1007/s00270-007-9114-6

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  • DOI: https://doi.org/10.1007/s00270-007-9114-6

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