Image Fusion Guidance with Pre-procedural CT with Real-Time Fluoroscopy for Adrenal Venous Sampling
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To assess the effectiveness of image fusion guidance (IF) with pre-procedural computed tomography (CT) with intraprocedural fluoroscopy for adrenal venous sampling (AVS).
Materials and Methods
AVS before and after ACTH stimulation including bilateral segmental sampling of effluent tributaries was performed in 62 patients with IF. A 3D volume rendering image, including adrenal glands and veins extracted from previously obtained contrast-enhanced CT images, was manually registered to the real-time X-ray fluoroscopy. The technical success rates, procedure time, radiation exposure, and volume of contrast medium used were compared with 49 patients who underwent AVS without IF.
No significant differences in the technical success rates with and without IF were observed (98.4 vs. 91.8% for the right adrenal veins, p = 0.168, and 98.4 vs. 100% for the left adrenal veins, p = 1.000). The procedure time with IF was significantly shorter than that without IF (95.6 ± 18.8 vs. 108.4 ± 20.0 min, p = 0.001). The total dose-area product with IF was significantly lower than that without IF (43.1 ± 30.7 vs. 72.2 ± 45.3 Gy cm2, p < 0.001). The contrast medium volume used with IF was significantly lower than that without IF (54.6 ± 21.9 vs. 65.7 ± 27.6 mL, p = 0.020).
Although the contribution to improving the technical success rates was small in our study, IF can effectively reduce procedure time, radiation exposure, and volume of contrast medium during AVS.
KeywordsAdrenal venous sampling AVS Interventional radiology Fusion Computed tomography
Compliance with Ethical Standards
Conflict of interest
All authors declare that there is no conflict of interest.
- 4.Young WF Jr, Klee GG. Primary aldosteronism. Diagnostic evaluation. Endocrinol Metab Clin N Am. 1988;17(2):367–95.Google Scholar
- 10.Nishikawa T, Matsuzawa Y, Saito J, Omura M. Is it possible to extirpate cardiovascular events in primary aldosteronism after surgical treatment. Jpn Clin Med. 2010;30(1):21–3.Google Scholar
- 12.Tacher V, Lin M, Desgranges P, Deux JF, Grünhagen T, Becquemin JP, Luciani A, Rahmouni A, Kobeiter H. Image guidance for endovascular repair of complex aortic aneurysms: comparison of two-dimensional and three-dimensional angiography and image fusion. J Vasc Interv Radiol. 2013;24(11):1698–706.CrossRefPubMedPubMedCentralGoogle Scholar
- 13.Bargellini I, Turini F, Bozzi E, Lauretti D, Cicorelli A, Lunardi A, Cioni R, Bartolozzi C. Image fusion of preprocedural CTA with real-time fluoroscopy to guide proper hepatic artery catheterization during transarterial chemoembolization of hepatocellular carcinoma: a feasibility study. Cardiovasc Interv Radiol. 2013;36(2):526–30.CrossRefGoogle Scholar
- 15.Miller DL, Vañó E, Bartal G, Cardiovascular and Interventional Radiology Society of Europe, Society of Interventional Radiology, et al. Occupational radiation protection in interventional radiology: a joint guideline of the Cardiovascular and Interventional Radiology Society of Europe and the Society of Interventional Radiology. J Vasc Interv Radiol. 2010;21(5):607–15.CrossRefPubMedGoogle Scholar