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Intraprocedural 3D perfusion measurement during chemoembolisation with doxorubicin-eluting beads in liver metastases of malignant melanoma

  • Interventional
  • Published:
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Abstract

Objectives

To study feasibility and validity of a new software application for intraprocedural assessment of perfusion during chemoembolisation of melanoma metastases.

Methodology

In a prospective phase-II trial, ten melanoma patients with liver-only metastases underwent chemoembolisation with doxorubicin-eluting beads (DEBDOX-TACE). Tumour perfusion was evaluated immediately before and after treatment at cone beam computer tomography (CBCT) using a new software application. For control and comparison, patients underwent perfusion measurement via contrast-enhanced multidetector CT (MDCT) before and after treatment.

Results

CBCT showed 94.7 % reduction in perfusion in metastases after DEBDOX-TACE, whereas MDCT showed 96.8 %. Reduction in perfusion after treatment was statistically significant (p < 0.01) for both methods. The additional time needed for data acquisition during treatment was 5 min per case or less; the post-processing data analysis was 10 min or less. Perfusion imaging was associated with additional contrast agent and patient exposure to radiation (dose-length product [DLP]): 18 ml and 394 mGy*cm in CBCT and 100 ml and 446 mGy*cm in MDCT, respectively.

Conclusions

Reduction in perfusion of melanoma metastases after DEBDOX-TACE can be reliably assessed during the intervention via perfusion software at CBCT. Data acquisition and analysis require additional time but can be easily performed during the treatment.

Key Points

• Tumour perfusion of melanoma metastases can be assessed at cone beam CT.

• The software shows a significant decrease of tumour perfusion after DEBDOX-TACE.

• Data acquisition and analysis require an acceptable additional time during the procedure.

• CBCT requires less radiation exposure and contrast for perfusion study than MSCT.

• This software can monitor the course of DEBDOX-TACE in melanoma metastases.

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Abbreviations

(c)TACE:

(conventional) Transarterial chemoembolisation

CBCT:

Cone beam computed tomography (synonym: C-arm CT)

DEB:

Drug-eluting beads

DOX:

Doxorubicin

HPI:

Hepatic Perfusion Index

MDCT:

Multidetector computed tomography (synonym Multislice-CT)

MM:

Malignant melanoma

PBV:

Parenchymal blood volume

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Funding

This study has received funding by Siemens Healthlineers Germany; drug-eluting beads were provided by BTG Biocompatibles UK.

Author information

Authors and Affiliations

  1. Clinic for Radiology, Minimally-Invasive Therapies and Nuclearmedicine, SLK-Kliniken GmbH, Heilbronn, Am Gesundbrunnen 20-26, 74078, Heilbronn, Germany

    Philippe L. Pereira, Kristina Krüger & Ernst Hohenstein

  2. Institute for Diagnostic and Interventional Radiology, Klinikum Ludwigsburg, Posilipostraße 4, 71640, Ludwigsburg, Germany

    Florian Welke

  3. Clinic for Diagnostic and Interventional Radiology, Ruprecht Karls University of Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Germany

    Christof Sommer

  4. Clinic for Dermato-Oncology, Universitätsklinikum Carl Gustav Carus, Fiedlerstraße 19, 01307, Dresden, Germany

    Friedegund Meier

  5. Clinic für Dermato-Oncology, Eberhard-Karls University, Liebermeisterstraße 25, 72076, Tübingen, Germany

    Thomas Eigentler & Claus Garbe

Authors
  1. Philippe L. Pereira
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  2. Kristina Krüger
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  3. Ernst Hohenstein
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  4. Florian Welke
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  5. Christof Sommer
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  6. Friedegund Meier
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  7. Thomas Eigentler
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  8. Claus Garbe
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Corresponding author

Correspondence to Philippe L. Pereira.

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Guarantor

The scientific guarantor of this publication is Philippe L Pereira.

Conflict of interest

The authors of this manuscript declare relationships with the following companies: A grant was received for cooperation on Interventional Oncology with Siemens Medical Solutions, which provides software and hardware for this study. PLP has received honoraria from BTG for advisory boards and conferences.

Statistics and biometry

One of the authors (KK) has significant statistical expertise.

Informed consent

Written informed consent was obtained from all subjects (patients) in this study.

Methodology

• prospective

• case-control study

• performed at one institution

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Pereira, P.L., Krüger, K., Hohenstein, E. et al. Intraprocedural 3D perfusion measurement during chemoembolisation with doxorubicin-eluting beads in liver metastases of malignant melanoma. Eur Radiol 28, 1456–1464 (2018). https://doi.org/10.1007/s00330-017-5099-y

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  • DOI: https://doi.org/10.1007/s00330-017-5099-y

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