UT Southwestern Medical Center, 5323 Harry Hines Blvd., 75390-9003 Dallas, TX, USA.
Division of Interventional Radiology, Department of Radiology, Rutgers New Jersey Medical School, MSB F-506, 07103 Newark, NJ, USA.
Diagn Interv Imaging. 2020 Jul-Aug;101(7-8):439-449. doi: 10.1016/j.diii.2020.01.011. Epub 2020 Feb 5.
The purpose of this study was to perform a systematic review of current literature describing the efficacy and technical outcomes of transarterial liver therapies using automated feeder detection (AFD) software.
This systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines. A structured search was performed in the PubMed, SCOPUS, and Embase databases of patients undergoing locoregional therapy of liver tumors utilizing AFD software. Demographic data, procedure data (including radiometrics) and tumor response rate were recorded. Where available, performance of AFD was compared to conventional digital subtraction angiography (DSA) and cone-beam CT (CBCT) without AFD.
A total of 14 full-text manuscripts met inclusion criteria, comprising 1042 tumors in 604 patients (305 men, 156 women; mean age, 68.6±6.0 [SD] years), including 537 patients with hepatocellular carcinoma, 8 with metastases from neuroendocrine tumors, and 59 patients without reported etiology. Reported sensitivity of AFD ranged between 86% and 98.5%, compared to DSA alone (38% - 64%) or DSA in combination with CBCT (69% - 81%). Three studies reported tumor response by modified response evaluation criteria in solid tumors (mRECIST) guidelines, with complete response in the range of 60% - 69%.
AFD is a promising new technology for the identification of intrahepatic and extrahepatic tumor-feeding arteries and should be considered a useful adjunct to conventional DSA and CBCT in the treatment of liver tumors.
本研究旨在对目前描述使用自动供血动脉检测（AFD）软件进行经动脉肝脏治疗的疗效和技术结果的文献进行系统评价。
本系统评价按照系统评价和荟萃分析的首选报告项目（PRISMA）指南进行。在 PubMed、SCOPUS 和 Embase 数据库中对接受使用 AFD 软件的肝肿瘤局部区域治疗的患者进行了结构化检索。记录了人口统计学数据、手术数据（包括放射学数据）和肿瘤反应率。在可用的情况下，将 AFD 的性能与传统数字减影血管造影（DSA）和锥形束 CT（CBCT）进行了比较，后者没有 AFD。
共有 14 篇全文文献符合纳入标准，包括 604 名患者的 1042 个肿瘤（305 名男性，156 名女性；平均年龄 68.6±6.0[SD]岁），其中 537 名患者患有肝细胞癌，8 名患者患有神经内分泌肿瘤转移，59 名患者无报告病因。与单独使用 DSA（38%-64%）或 DSA 联合 CBCT（69%-81%）相比，AFD 的报告灵敏度在 86%至 98.5%之间。有 3 项研究按照实体瘤反应评估标准（mRECIST）报告了肿瘤反应，完全缓解率在 60%-69%之间。
AFD 是一种很有前途的新技术，用于识别肝内和肝外肿瘤供血动脉，在治疗肝肿瘤时，应被视为常规 DSA 和 CBCT 的有用辅助手段。
