C-arm computed tomography compared with positron emission tomography/computed tomography for treatment planning before radioembolization

Cardiovasc Intervent Radiol. 2011 Jun;34(3):550-6. doi: 10.1007/s00270-010-9897-8. Epub 2010 May 29.

Abstract

The purpose of this study was to determine whether rotational C-arm computed tomography (CT) allows visualization of liver metastases and adds relevant information for radioembolization (RE) treatment planning. Technetium angiography, together with C-arm CT, was performed in 47 patients to determine the feasibility for RE. C-arm CT images were compared with positron emission tomography (PET)/CT images for the detection of liver tumors. The images were also rated according one of the following three categories: (1) images that provide no additional information compared with DSA alone; (2) images that do provide additional information compared with DSA; and (2) images that had an impact on eligibility determination for and planning of the RE procedure. In all patients, 283 FDG-positive liver lesions were detected by PET. In venous contrast-phase CT, 221 (78.1%) and 15 (5.3%) of these lesions were either hypodense or hyperdense, respectively. In C-arm CT, 103 (36.4%) liver lesions were not detectable because they were outside of either the field of view or the contrast-enhanced liver segment. Another 25 (8.8%) and 98 (34.6%) of the liver lesions were either hyperdense or presented primarily as hypodense lesions with a rim enhancement, respectively. With PET/CT as the standard of reference, venous CT and C-arm CT failed to detect 47 (16.6%) and 57 (20.1%) of all liver lesions, respectively. For RE planning, C-arm CT provided no further information, provide some additional information, or had an impact on the procedure in 20 (42.5%), 15 (31.9%) and 12 (25.6%) of patients, respectively. We conclude that C-arm CT may add decisive information in patients scheduled for RE.

Publication types

  • Comparative Study

MeSH terms

  • Angiography, Digital Subtraction
  • Contrast Media
  • Embolization, Therapeutic
  • Feasibility Studies
  • Female
  • Humans
  • Iohexol / analogs & derivatives
  • Iopamidol / analogs & derivatives
  • Liver Neoplasms / diagnostic imaging*
  • Liver Neoplasms / secondary
  • Male
  • Microspheres
  • Middle Aged
  • Neoplasm Seeding
  • Positron-Emission Tomography / methods*
  • Radiography, Interventional
  • Radiopharmaceuticals
  • Technetium Tc 99m Aggregated Albumin
  • Tomography, X-Ray Computed / methods*
  • Yttrium Radioisotopes

Substances

  • Contrast Media
  • Radiopharmaceuticals
  • Technetium Tc 99m Aggregated Albumin
  • Yttrium Radioisotopes
  • iomeprol
  • Iohexol
  • iopromide
  • Iopamidol