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Quantitative Real-Time Fluoroscopy Analysis on Measurement of the Hepatic Arterial Flow During Transcatheter Arterial Chemoembolization of Hepatocellular Carcinoma: Comparison with Quantitative Digital Subtraction Angiography Analysis

  • Clinical Investigation
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Abstract

Purpose

To quantify the arterial flow change during transcatheter arterial chemoembolization (TACE) for hepatocellular carcinoma (HCC) using digital subtraction angiography, quantitative color-coding analysis (d-QCA), and real-time subtraction fluoroscopy QCA (f-QCA).

Materials and Methods

This prospective study enrolled 20 consecutive patients with HCC who had undergone TACE via a subsegmental approach between February 2014 and April 2015. The TACE endpoint was a sluggish antegrade tumor-feeding arterial flow. d-QCA and f-QCA were used for determining the relative maximal density time (rTmax) of the selected arteries. The rTmax of the selected arteries was analyzed in d-QCA and f-QCA before and after TACE, and its correlation in both analyses was evaluated.

Results

The pre- and post-TACE rTmax of the embolized segmental artery in d-QCA and f-QCA were 1.59 ± 0.81 and 2.97 ± 1.80 s (P < 0.001) and 1.44 ± 0.52 and 2.28 ± 1.02 s (P < 0.01), respectively. The rTmax of the proximal hepatic artery did not significantly change during TACE in d-QCA and f-QCA. The Spearman correlation coefficients of the pre- and post-TACE rTmax of the embolized segmental artery between d-QCA and f-QCA were 0.46 (P < 0.05) and 0.80 (P < 0.001). Radiation doses in one series of d-QCA and f-QCA were 140.7 ± 51.5 milligray (mGy) and 2.5 ± 0.7 mGy, respectively.

Conclusions

f-QCA can quantify arterial flow changes with a higher temporal resolution and lower radiation dose. Flow quantification of the embolized segmental artery using f-QCA and d-QCA is highly correlated.

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Acknowledgments

The authors acknowledge the support provided by Taipei Veterans General Hospital and Siemens Healthcare (Grant number: T1100200).

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Authors and Affiliations

  1. Department of Radiology, Taipei Veterans General Hospital, No. 201, Sec. 2, Shipai Rd., Beitou District, Taipei, Taiwan

    Yi-Yang Lin, Rheun-Chuan Lee, Wan-Yuo Guo & Wei-Fa Chu

  2. Institute of Clinical Medicine, National Yang-Ming University, No. 155, Sec. 2, Linong Street, Taipei, 112, Taiwan

    Yi-Yang Lin

  3. School of Medicine, National Yang-Ming University, No. 155, Sec. 2, Linong Street, Taipei, 112, Taiwan

    Yi-Yang Lin, Rheun-Chuan Lee & Wan-Yuo Guo

  4. Siemens Healthcare Ltd., 2F-2, No. 3, Park St., Nangang District, Taipei, 115, Taiwan

    Frank Chun-Hsien Wu

  5. Siemens Healthcare GmbH, Siemensstraße 1, 91301, Forchheim, Germany

    Sonja Gehrisch

Authors
  1. Yi-Yang Lin
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  2. Rheun-Chuan Lee
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  3. Wan-Yuo Guo
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  4. Wei-Fa Chu
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  5. Frank Chun-Hsien Wu
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Corresponding authors

Correspondence to Rheun-Chuan Lee or Wan-Yuo Guo.

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Conflict of Interest

Dr. Chu reports grants from Siemens Healthcare for a collaboration contract between Taipei Veterans General Hospital and Siemens Healthcare during the conduct of the study. Frank Chun-Hsien Wu and Sonja Gehrisch are employees of Siemens Healthcare. On behalf of all authors, the corresponding author states that there is no conflict of interest.

Statement of Informed Consent

Informed consent was obtained from all individual participants included in the study.

Statement of Human Right

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Lin, YY., Lee, RC., Guo, WY. et al. Quantitative Real-Time Fluoroscopy Analysis on Measurement of the Hepatic Arterial Flow During Transcatheter Arterial Chemoembolization of Hepatocellular Carcinoma: Comparison with Quantitative Digital Subtraction Angiography Analysis. Cardiovasc Intervent Radiol 39, 1557–1563 (2016). https://doi.org/10.1007/s00270-016-1421-3

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  • DOI: https://doi.org/10.1007/s00270-016-1421-3

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