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18-01-2023 | Computed Tomography | Imaging Informatics and Artificial Intelligence

Accuracy and reproducibility of a cone beam CT-based virtual parenchymal perfusion algorithm in the prediction of SPECT/CT anatomical and volumetric results during the planification of radioembolization for HCC

Authors: Haytham Derbel, Mahdi Krichen, Julia Chalaye, Laetitia Saccenti, William Van der Sterren, Anne-Hilde Muris, Lionel Lerman, Athena Galletto, Youssef Zaarour, Alain Luciani, Hicham Kobeiter, Vania Tacher

Published in: European Radiology | Issue 5/2023

Abstract

Objectives

To evaluate anatomical and volumetric predictability of a cone beam computed tomography (CBCT)-based virtual parenchymal perfusion (VPP) software for the single-photon-emission computed tomography (SPECT)/CT imaging results during the work-up for transarterial radioembolization (TARE) procedure in patients with hepatocellular carcinoma (HCC).

Methods

VPP was evaluated retrospectively on CBCT data of patients treated by TARE for HCC. ^99mTc macroaggregated albumin particles (^99mTc-MAA) uptake territories on work-up SPECT/CT was used as ground truth for the evaluation. Semi-quantitative evaluation consisted of the ranking of visual consistency of the parenchymal enhancement and portal vein tumoral involvement on VPP and ^99mTc-MAA SPECT/CT, using a three-rank scale and two-rank scale, respectively. Inter-reader agreement was evaluated using a kappa coefficient. Quantitative evaluation included absolute volume error calculation and Pearson correlation between volumes enhanced territories on VPP and ^99mTc-MAA SPECT/CT.

Results

Fifty-two CBCTs were performed in 33 included patients. Semi-quantitative evaluation showed a good concordance between actual ^99mTc-MAA uptake and the virtual enhanced territories in 73% and 75% of cases; a mild concordance in 12% and 10% and a poor concordance in 15%, for the two readers. Kappa coefficient was 0.86. Portal vein involvement evaluation showed a good concordance in 58.3% and 66.7% for the two readers, respectively, with a kappa coefficient of 0.82. Quantitative evaluation showed a volume error of 0.46 ± 0.78 mL [0.01–3.55], and Pearson R² factor at 0.75 with a p value < 0.01.

Conclusion

CBCT-based VPP software is accurate and reliable to predict ^99mTc-MAA SPECT/CT anatomical and volumetric results in HCC patients during TARE.

Key Points

• Virtual parenchymal perfusion (VPP) software is accurate and reliable in the prediction of ^99m Tc-MAA SPECT volumetric and targeting results in HCC patients during transarterial radioembolization (TARE).

• VPP software may be used per-operatively to optimize the microcatheter position for ⁹⁰ Y infusion allowing precise tumor targeting while preserving non-tumoral parenchyma.

• Post-operatively, VPP software may allow an accurate estimation of the perfused volume by each arterial branch and, thus, a precise ⁹⁰ Y dosimetry for TARE procedures.

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Title: Accuracy and reproducibility of a cone beam CT-based virtual parenchymal perfusion algorithm in the prediction of SPECT/CT anatomical and volumetric results during the planification of radioembolization for HCC
Authors: Haytham Derbel
Mahdi Krichen
Julia Chalaye
Laetitia Saccenti
William Van der Sterren
Anne-Hilde Muris
Lionel Lerman
Athena Galletto
Youssef Zaarour
Alain Luciani
Hicham Kobeiter
Vania Tacher
Publication date: 18-01-2023
Publisher: Springer Berlin Heidelberg
Keywords: Computed Tomography
Computed Tomography
Digital Volume Tomography
Hepatocellular Carcinoma
Digital Volume Tomography
Hepatocellular Carcinoma
Published in: European Radiology / Issue 5/2023
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-023-09390-w

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Accuracy and reproducibility of a cone beam CT-based virtual parenchymal perfusion algorithm in the prediction of SPECT/CT anatomical and volumetric results during the planification of radioembolization for HCC

Abstract

Objectives

Methods

Results

Conclusion

Key Points

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objectives

Methods

Results

Conclusion

Key Points

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