Ertreo Marco, Choi Hailey, Field David, Lischalk Jonathan W, Cohen Emil, Lynskey George E, Caridi Theresa, Buckley Donna, Unger Keith, Kim Alexander Y
Division of Interventional Radiology, Department of Radiology, Medstar Georgetown University Hospital, 3800 Reservoir Rd NW, Washington, DC, 20007, USA.
Department of Radiation Oncology, Medstar Georgetown University Hospital, 3800 Reservoir Rd NW, Washington, DC, 20007, USA.
Cardiovasc Intervent Radiol. 2018 Dec;41(12):1857-1866. doi: 10.1007/s00270-018-2030-0. Epub 2018 Jul 13.
To compare the use of cone-beam computed tomography versus contrast-enhanced computed tomography (CT) and magnetic resonance imaging (MRI) in the calculation of liver volume and planned dose for yttrium-90 radioembolization.
The study retrospectively assessed 47 consecutive patients who underwent resin Y-90 radioembolization consecutively over a 2-year period at a single center. Volume calculation software was used to determine perfused lobar liver volumes from cone-beam CT (CBCT) images obtained during mapping angiography. CBCT-derived volumes were compared with perfused lobar volume derived from contrast-enhanced CT and MRI. Nominal activities as determined by the SIR-Spheres Microspheres Activity Calculator were similarly calculated and compared using both CBCT and conventionally acquired volumes.
A total of 82 hepatic lobes were assessed in 47 patients. The mean percentage difference between combined CT-MRI- and CBCT-derived calculated lobar volumes was 25.3% (p = 0.994). The mean percentage difference in calculated dose between the two methods was 21.8 ± 24.6% (p = 0.42). Combined left and right lobar CT-derived dose difference was less than 10% in 22 lobes, between 10 and 25% in 20 lobes, between 25 and 50% in 13 lobes and greater than 50% in 5 lobes. Combined left and right lobar MRI-derived dose difference was less than 10% in 11 lobes, between 10 and 25% in 7 lobes, between 25 and 50% in 2 lobes and greater than 50% in 1 lobe.
Although volume measurements derived from CT/MRI did not differ significantly from those derived from CBCT, variability between the two methods led to large and unexpected differences in calculated dose.
比较锥形束计算机断层扫描与对比增强计算机断层扫描（CT）及磁共振成像（MRI）在钇-90放射性栓塞治疗中肝脏体积计算和计划剂量方面的应用。
本研究回顾性评估了在单一中心连续2年期间接受树脂Y-90放射性栓塞治疗的47例患者。使用体积计算软件从在映射血管造影期间获得的锥形束CT（CBCT）图像确定灌注的肝叶体积。将CBCT得出的体积与对比增强CT和MRI得出的灌注肝叶体积进行比较。使用CBCT和传统获取的体积类似地计算并比较由SIR-Spheres微球活性计算器确定的标称活度。
共评估了47例患者的82个肝叶。CT-MRI联合得出的计算肝叶体积与CBCT得出的计算肝叶体积之间的平均百分比差异为25.3%（p = 0.994）。两种方法计算剂量的平均百分比差异为21.8±24.6%（p = 0.42）。联合左右肝叶CT得出的剂量差异在22个肝叶中小于10%，在20个肝叶中介于10%至25%之间，在13个肝叶中介于25%至50%之间，在5个肝叶中大于50%。联合左右肝叶MRI得出的剂量差异在11个肝叶中小于10%，在7个肝叶中介于10%至25%之间，在2个肝叶中介于25%至50%之间，在1个肝叶中大于50%。
尽管CT/MRI得出的体积测量值与CBCT得出的体积测量值无显著差异，但两种方法之间的变异性导致计算剂量出现大的意外差异。
