Utility of the Virtual Liver Parenchymal Perfusion Area Using a Commercially Available Workstation in Transarterial Chemoembolization for Hepatocellular Carcinoma
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To evaluate the accuracy of the virtual liver parenchymal perfusion area using a commercially available workstation and liver analysis software in conventional transarterial chemoembolization (cTACE) for hepatocellular carcinoma (HCC).
Materials and Methods
This method was retrospectively applied to 29 treated HCCs in 23 patients. The virtual embolic area (VEA) was estimated based on cone beam computed tomography during hepatic arteriography using a commercially available workstation and liver analysis software by two observer groups (group A: experts; group B: semi-experts). The real embolic area (REA) was defined as the area where iodized oil accumulated on computed tomography at 1 week after cTACE. The REA was estimated by each of the two groups, and the mean REA between the groups (mREA) was used as a standard reference. Agreement of volume and cross-sectional area in three orthogonal planes between the VEA and mREA were analyzed using intraclass correlation coefficients (ICCs) and Bland–Altman plots.
The ICCs for volume between VEA and mREA were 0.97 and 0.88 for groups A and B, respectively, and those for cross-sectional area were 0.94 and 0.88 for the axial plane, 0.95 and 0.83 for the coronal plane, and 0.87 and 0.74 for the sagittal plane, respectively. Thus, the overall agreement was excellent, except for the sagittal imaging plane in group B.
This method using a commercially available workstation and liver analysis software can be useful for estimating the embolic area in cTACE.
KeywordsCone beam computed tomography Hepatocellular carcinoma Transarterial chemoembolization 3-Dimensional workstation Real embolic area Virtual embolic area Virtual liver parenchymal perfusion area
The authors would like to thank Yoshihiro Okayama (Clinical Trial Center for Development Therapeutics, Tokushima University Hospital) for his assistance with statistical analysis.
Compliance with Ethical Standards
Conflict of interest
The authors declared that they have no conflict of interest.
All procedures performed in studies involving human participants were in accordance with the ethics of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed consent was obtained from all individual participants included in the study.
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