Top

Published in:

01-01-2020 | Angiography | Interventional

Clinical impact of a new cone beam CT angiography respiratory motion artifact reduction algorithm during hepatic intra-arterial interventions

Authors: Marco Dioguardi Burgio, Thomas Benseghir, Vincent Roche, Carmela Garcia Alba, Jean Baptiste Debry, Annie Sibert, Valérie Vilgrain, Maxime Ronot

Published in: European Radiology | Issue 1/2020

Abstract

Objectives

To assess the impact of recently developed respiratory motion correction software on contrast-enhanced cone beam CT angiography (CBCT-a) for intraprocedural image guidance during intra-arterial liver-directed therapy.

Methods

From 2015 to 2017, two groups of patients who underwent intra-arterial liver-directed therapy with (breathing, n = 30) or without (still, n = 30) significant respiratory motion artifacts were retrospectively included. All CBCT-a were processed with and without dedicated respiratory motion correction software. Four readers independently assessed the following in both reconstructions (motion correction ON and OFF): (1) overall image quality on a 0-to-5 point scale, and (2) presence of relevant peri-procedural information on tumor and vasculature (overall vessel geometry, visibility of extrahepatic vessels, target tumor conspicuity, visibility of tumor feeders).

Results

Motion correction increased the average image quality in the breathing group from 2.0 ± 0.9 to 2.9 ± 1.0 (p < 0.01). The visibility of vessel geometry, extrahepatic vessels, and tumor feeders was significantly improved for all readers, and tumor conspicuity was improved for three readers. The average image quality was not significantly different between reconstructions in the still group (motion correction ON and OFF), for any of the readers (4.0 ± 0.6 vs 4.2 ± 0.6; p = 0.12). There was no change in the visibility of vessel geometry, extrahepatic vessels, tumor feeders, or tumor conspicuity for the four readers using the respiratory motion correction software in this group.

Conclusions

Using the dedicated respiratory motion correction software during intra-arterial liver-directed procedures increases the visualization of relevant peri-procedural information and image quality in CBCT-a corrupted by respiratory motion artifacts without affecting these elements in still CBCT-a.

Key Points

• The use of respiratory motion correction software could reduce the need for cone beam CT angiography acquisition retake.

• Motion correction software significantly increases the visibility of vessel geometry, extrahepatic vessels, and tumor feeders, as well as tumor conspicuity in cone beam CT angiography corrupted by respiratory motion artifacts.

• The use of respiratory motion correction software on cone beam CT angiography uncorrupted by respiratory motion artifact does not result in decreased image quality.

Available only for authorised users

Raj S, Irani FG, Tay KH, Tan BS (2013) C-arm cone beam computed tomography: a new tool in the interventional suite. Ann Acad Med Singapore 42:585–592PubMed

Tacher V, Radaelli A, Lin M, Geschwind JF (2015) How I do it: cone-beam CT during transarterial chemoembolization for liver cancer. Radiology 274:320–334. https://doi.org/10.1148/radiol.14131925

Minami Y, Yagyu Y, Murakami T, Kudo M (2014) Tracking navigation imaging of transcatheter arterial chemoembolization for hepatocellular carcinoma using three-dimensional cone-beam CT angiography. Liver Cancer 3:53–61. https://doi.org/10.1159/000343858 CrossRefPubMedPubMedCentral

Miyayama S, Yamashiro M, Hashimoto M et al (2013) Identification of small hepatocellular carcinoma and tumor-feeding branches with cone-beam CT guidance technology during transcatheter arterial chemoembolization. J Vasc Interv Radiol 24:501–508. https://doi.org/10.1016/j.jvir.2012.12.022 CrossRefPubMed

Iwazawa J, Ohue S, Mitani T et al (2009) Identifying feeding arteries during TACE of hepatic tumors: comparison of C-arm CT and digital subtraction angiography. AJR Am J Roentgenol 192:1057–1063. https://doi.org/10.2214/AJR.08.1285 CrossRefPubMed

Pung L, Ahmad M, Mueller K et al (2017) The role of cone-beam CT in transcatheter arterial chemoembolization for hepatocellular carcinoma: a systematic review and meta-analysis. J Vasc Interv Radiol 28:334–341. https://doi.org/10.1016/j.jvir.2016.11.037 CrossRefPubMed

Lee IJ, Chung JW, Yin YH et al (2014) Cone-beam CT hepatic arteriography in chemoembolization for hepatocellular carcinoma: angiographic image quality and its determining factors. J Vasc Interv Radiol 25:1369–1379; quiz 1379-.e1. https://doi.org/10.1016/j.jvir.2014.04.011 CrossRefPubMed

Jonczyk M, Collettini F, Geisel D et al (2018) Radiation exposure during TACE procedures using additional cone-beam CT (CBCT) for guidance: safety and precautions. Acta Radiol 59:1277–1284. https://doi.org/10.1177/0284185118761203 CrossRefPubMed

Kothary N, Abdelmaksoud MH, Tognolini A et al (2011) Imaging guidance with C-arm CT: prospective evaluation of its impact on patient radiation exposure during transhepatic arterial chemoembolization. J Vasc Interv Radiol 22:1535–1543. https://doi.org/10.1016/j.jvir.2011.07.008

10.

de Baere T, Arai Y, Lencioni R et al (2016) Treatment of liver tumors with lipiodol TACE: technical recommendations from experts opinion. Cardiovasc Intervent Radiol 39:334–343. https://doi.org/10.1007/s00270-015-1208-y CrossRefPubMed

11.

Gaba RC, Lokken RP, Hickey RM et al (2017) Quality improvement guidelines for transarterial chemoembolization and embolization of hepatic malignancy. J Vasc Interv Radiol 28:1210–1223.e3. https://doi.org/10.1016/j.jvir.2017.04.025 CrossRefPubMed

12.

Tognolini A, Louie JD, Hwang GL, Hofmann LV, Sze DY, Kothary N (2010) Utility of C-arm CT in patients with hepatocellular carcinoma undergoing transhepatic arterial chemoembolization. J Vasc Interv Radiol 21:339–347. https://doi.org/10.1016/j.jvir.2009.11.007

13.

Kim H-C (2015) Role of C-arm cone-beam CT in chemoembolization for hepatocellular carcinoma. Korean J Radiol 16:114–124. https://doi.org/10.3348/kjr.2015.16.1.114 CrossRefPubMedPubMedCentral

14.

Klugmann A, Bier B, Müller K, Maier A, Unberath M (2018) Deformable respiratory motion correction for hepatic rotational angiography. Comput Med Imaging Graph 66:82–89. https://doi.org/10.1016/j.compmedimag.2018.03.003

15.

Sindel A, Bögel M, Maier A, Fahrig R, Hornegger J, Dörfler A (2015) Respiratory motion compensation for C-arm CT liver imaging. In: Handels H, Deserno TM, Meinzer HP, Tolxdorff T (eds) Bildverarbeitung für die Medizin 2015. Springer Berlin Heidelberg, Berlin, Heidelberg, pp 221–226

Title: Clinical impact of a new cone beam CT angiography respiratory motion artifact reduction algorithm during hepatic intra-arterial interventions
Authors: Marco Dioguardi Burgio
Thomas Benseghir
Vincent Roche
Carmela Garcia Alba
Jean Baptiste Debry
Annie Sibert
Valérie Vilgrain
Maxime Ronot
Publication date: 01-01-2020
Publisher: Springer Berlin Heidelberg
Keywords: Angiography
Digital Volume Tomography
Digital Volume Tomography
CT Angiography
Published in: European Radiology / Issue 1/2020
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-019-06355-w

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Clinical impact of a new cone beam CT angiography respiratory motion artifact reduction algorithm during hepatic intra-arterial interventions

Abstract

Objectives

Methods

Results

Conclusions

Key Points

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Objectives

Methods

Results

Conclusions

Key Points

Please log in to get access to this content

Other articles of this Issue 1/2020

Compressed sensing real-time cine imaging for assessment of ventricular function, volumes and mass in clinical practice

Baseline 3D-ADC outperforms 2D-ADC in predicting response to treatment in patients with colorectal liver metastases

Radiomics machine-learning signature for diagnosis of hepatocellular carcinoma in cirrhotic patients with indeterminate liver nodules

Performance of gadoxetic acid MRI and diffusion-weighted imaging for the diagnosis of early recurrence of hepatocellular carcinoma

Noncontrast computer tomography–based radiomics model for predicting intracerebral hemorrhage expansion: preliminary findings and comparison with conventional radiological model

Gadoxetate disodium-related event during image acquisition: a prospective multi-institutional study for better MR practice