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Ultrafast cone-beam computed tomography: a comparative study of imaging protocols during image-guided therapy procedure.

Paul J, Chacko A, Farhang M, Kamali S, Tavanania M, Vogl T, Panahi B - Biomed Res Int (2015)

Bottom Line: Contrast injection volume and dose parameters were compared using values from the literature.Imaging protocol 2 provided significantly better (P < 0.05) image quality than protocol 1 at the cost of slightly higher contrast load and patient dose.A reduction of required contrast volume and patient dose were achieved due to the ultrafast CBCT imaging.

View Article: PubMed Central - PubMed

Affiliation: Diagnostic and Interventional Radiology, University Hospital, Goethe University Frankfurt, Theodor-Stern-Kai 7, 60590 Frankfurt, Germany.

ABSTRACT

Objective: To evaluate two ultrafast cone-beam CT (UF-CBCT) imaging protocols with different acquisition and injection parameters regarding image quality and required contrast media during image-guided hepatic transarterial chemoembolization (TACE).

Methods: In 80 patients (male: 46, female: 34; mean age: 56.8 years; range: 33-83) UF-CBCT was performed during TACE for intraprocedural guidance. Imaging was performed using two ultrafast CBCT acquisition protocols with different acquisition and injection parameters (imaging protocol 1: acquisition time 2.54 s, and contrast 6 mL with 3 s delay; imaging protocol 2: acquisition time 2.72 s, and contrast 7 mL with 6 s delay). Image evaluation was performed with both qualitative and quantitative methods. Contrast injection volume and dose parameters were compared using values from the literature.

Results: Imaging protocol 2 provided significantly better (P < 0.05) image quality than protocol 1 at the cost of slightly higher contrast load and patient dose. Imaging protocol 1 provided good contrast perfusion but it mostly failed to delineate the tumors (P < 0.05). On the contrary, imaging protocol 2 showed excellent enhancement of hepatic parenchyma, tumor, and feeding vessels.

Conclusion: Tumor delineation, visualization of hepatic parenchyma, and feeding vessels are clearly possible using imaging protocol 2 with ultrafast CBCT imaging. A reduction of required contrast volume and patient dose were achieved due to the ultrafast CBCT imaging.

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Frames (a) and (b) represented the images obtained from a 62-year-old patient during TACE therapy, generated using ultrafast cone-beam CT with imaging protocol 1. Pretreatment magnetic resonance cross-sectional images ((c) and (f)) show a clear view of embedded tumor in the hepatic parenchyma. Hepatic tumor detection was insufficient using imaging protocol 1 data (tumor indicated using black arrow) compared to imaging protocol 2 due to a reduction of contrast material in the tumors. Coronal reconstructed images ((d) and (e)) were acquired using imaging protocol 2 during a 60-year-old patient TACE examination. The images show excellent tumor(s), feeding vessels, and hepatic parenchymal visualization; furthermore, notice the strong contrast material enhancement of the tumors with little or no artifacts.
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fig1: Frames (a) and (b) represented the images obtained from a 62-year-old patient during TACE therapy, generated using ultrafast cone-beam CT with imaging protocol 1. Pretreatment magnetic resonance cross-sectional images ((c) and (f)) show a clear view of embedded tumor in the hepatic parenchyma. Hepatic tumor detection was insufficient using imaging protocol 1 data (tumor indicated using black arrow) compared to imaging protocol 2 due to a reduction of contrast material in the tumors. Coronal reconstructed images ((d) and (e)) were acquired using imaging protocol 2 during a 60-year-old patient TACE examination. The images show excellent tumor(s), feeding vessels, and hepatic parenchymal visualization; furthermore, notice the strong contrast material enhancement of the tumors with little or no artifacts.

Mentions: Details of the patient hepatic tumor characteristics obtained using gold standard MRI are displayed in Table 3 and tumor characteristics determined using images of both UF-CBCT imaging protocols are provided in Table 4. The evaluated imaging protocol 2 produced an excellent tumor delineation, contrast perfusion, and parenchymal visualization (Figure 1; Table 5) with adequate enhancement due to the use of proper bolus timing, mixing ratio, and X-ray delay time during ultrafast imaging. However, using imaging protocol 1 the identification of hepatic tumors was difficult because of reduced contrast material (Figure 1) as a result of improper delay time for ultrafast imaging. Qualitative analysis showed large difference of image quality between the two imaging protocols (Table 5). Image quality was significantly higher (all P < 0.05) in imaging protocol 2 compared to imaging protocol 1 (Table 5; Figure 1). Interreader agreement performed using Kappa during qualitative analysis showed almost perfect agreement (K = 0.832–0.947).


Ultrafast cone-beam computed tomography: a comparative study of imaging protocols during image-guided therapy procedure.

Paul J, Chacko A, Farhang M, Kamali S, Tavanania M, Vogl T, Panahi B - Biomed Res Int (2015)

Frames (a) and (b) represented the images obtained from a 62-year-old patient during TACE therapy, generated using ultrafast cone-beam CT with imaging protocol 1. Pretreatment magnetic resonance cross-sectional images ((c) and (f)) show a clear view of embedded tumor in the hepatic parenchyma. Hepatic tumor detection was insufficient using imaging protocol 1 data (tumor indicated using black arrow) compared to imaging protocol 2 due to a reduction of contrast material in the tumors. Coronal reconstructed images ((d) and (e)) were acquired using imaging protocol 2 during a 60-year-old patient TACE examination. The images show excellent tumor(s), feeding vessels, and hepatic parenchymal visualization; furthermore, notice the strong contrast material enhancement of the tumors with little or no artifacts.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4385616&req=5

fig1: Frames (a) and (b) represented the images obtained from a 62-year-old patient during TACE therapy, generated using ultrafast cone-beam CT with imaging protocol 1. Pretreatment magnetic resonance cross-sectional images ((c) and (f)) show a clear view of embedded tumor in the hepatic parenchyma. Hepatic tumor detection was insufficient using imaging protocol 1 data (tumor indicated using black arrow) compared to imaging protocol 2 due to a reduction of contrast material in the tumors. Coronal reconstructed images ((d) and (e)) were acquired using imaging protocol 2 during a 60-year-old patient TACE examination. The images show excellent tumor(s), feeding vessels, and hepatic parenchymal visualization; furthermore, notice the strong contrast material enhancement of the tumors with little or no artifacts.
Mentions: Details of the patient hepatic tumor characteristics obtained using gold standard MRI are displayed in Table 3 and tumor characteristics determined using images of both UF-CBCT imaging protocols are provided in Table 4. The evaluated imaging protocol 2 produced an excellent tumor delineation, contrast perfusion, and parenchymal visualization (Figure 1; Table 5) with adequate enhancement due to the use of proper bolus timing, mixing ratio, and X-ray delay time during ultrafast imaging. However, using imaging protocol 1 the identification of hepatic tumors was difficult because of reduced contrast material (Figure 1) as a result of improper delay time for ultrafast imaging. Qualitative analysis showed large difference of image quality between the two imaging protocols (Table 5). Image quality was significantly higher (all P < 0.05) in imaging protocol 2 compared to imaging protocol 1 (Table 5; Figure 1). Interreader agreement performed using Kappa during qualitative analysis showed almost perfect agreement (K = 0.832–0.947).

Bottom Line: Contrast injection volume and dose parameters were compared using values from the literature.Imaging protocol 2 provided significantly better (P < 0.05) image quality than protocol 1 at the cost of slightly higher contrast load and patient dose.A reduction of required contrast volume and patient dose were achieved due to the ultrafast CBCT imaging.

View Article: PubMed Central - PubMed

Affiliation: Diagnostic and Interventional Radiology, University Hospital, Goethe University Frankfurt, Theodor-Stern-Kai 7, 60590 Frankfurt, Germany.

ABSTRACT

Objective: To evaluate two ultrafast cone-beam CT (UF-CBCT) imaging protocols with different acquisition and injection parameters regarding image quality and required contrast media during image-guided hepatic transarterial chemoembolization (TACE).

Methods: In 80 patients (male: 46, female: 34; mean age: 56.8 years; range: 33-83) UF-CBCT was performed during TACE for intraprocedural guidance. Imaging was performed using two ultrafast CBCT acquisition protocols with different acquisition and injection parameters (imaging protocol 1: acquisition time 2.54 s, and contrast 6 mL with 3 s delay; imaging protocol 2: acquisition time 2.72 s, and contrast 7 mL with 6 s delay). Image evaluation was performed with both qualitative and quantitative methods. Contrast injection volume and dose parameters were compared using values from the literature.

Results: Imaging protocol 2 provided significantly better (P < 0.05) image quality than protocol 1 at the cost of slightly higher contrast load and patient dose. Imaging protocol 1 provided good contrast perfusion but it mostly failed to delineate the tumors (P < 0.05). On the contrary, imaging protocol 2 showed excellent enhancement of hepatic parenchyma, tumor, and feeding vessels.

Conclusion: Tumor delineation, visualization of hepatic parenchyma, and feeding vessels are clearly possible using imaging protocol 2 with ultrafast CBCT imaging. A reduction of required contrast volume and patient dose were achieved due to the ultrafast CBCT imaging.

Show MeSH
Related in: MedlinePlus