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European Radiology
Published in: European Radiology 10/2019

01-10-2019 | Computed Tomography | Computed Tomography

Is dual-phase C-arm CBCT sufficiently accurate for the diagnosis of colorectal cancer liver metastasis during liver intra-arterial treatment?

Authors: Olivier Pellerin, Helena Pereira, Claire Van Ngoc Ty, Nadia Moussa, Costantino Del Giudice, Simon Pernot, Carole Déan, Gilles Chatellier, Marc Sapoval

Published in: European Radiology | Issue 10/2019

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Abstract

Purpose

This study aimed to estimate the accuracy of dual-phase C-arm cone beam computed tomography (CBCT) for the detection of colorectal cancer liver metastases, as compared with multidetector computed tomography (MDCT).

Materials and methods

Between March 2014 and December 2016, 49 consecutive patients referred for intra-arterial treatment for colorectal cancer liver metastases were enrolled in a single-center observational study. All patients were examined with MDCT and with dual-phase C-arm cone beam computed tomography performed after iodine injection in the proper hepatic artery before intra-arterial treatment. Two blinded observers independently reviewed all examinations. Diagnostic accuracy was determined using both a six-cell matrix method and a “worst-case scenario.”

Results

Readers identified at MDCT 264 colorectal liver metastases and 43 other liver lesions. The early and late arterial phase showed 240 and 277 liver lesions respectively. A certainty of the diagnosis was obtained in 63% and 85% at the early (EAP) and late arterial phase (LAP), respectively. Streak artifacts or liver segment truncation, or inadequate enhancement was responsible for the inability to see or to correctly adjudicate a lesion to a diagnosis in 27% and 15% of the cases at the EAP and LAP. The “worst-case scenario” yielded a Se and Sp of 58% and 51%, respectively, at EAP and 84% and 70%, respectively, at LAP.

Conclusion

On CBCT, EAP showed limited accuracy. LAP provided the best tumor detectability.

Key Points

• The early arterial phase (EAP) yielded poor accuracy: Se = 58% and Sp = 51% (p < 0.0001).
• The late arterial phase (LAP) phase yielded good accuracy: Se = 84% and Se = 70% (p = 0.02).
• The probability of a correct diagnosis at the EAP was 60%.
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Metadata
Title
Is dual-phase C-arm CBCT sufficiently accurate for the diagnosis of colorectal cancer liver metastasis during liver intra-arterial treatment?
Authors
Olivier Pellerin
Helena Pereira
Claire Van Ngoc Ty
Nadia Moussa
Costantino Del Giudice
Simon Pernot
Carole Déan
Gilles Chatellier
Marc Sapoval
Publication date
01-10-2019
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 10/2019
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-019-06173-0

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