Radiology Department, Interventional Radiology Service, Memorial Sloan Kettering Cancer Center, 1275 York Avenue H-118, New York , NY, USA.
GE Healthcare - 283 rue de la minière, Buc, France.
Cardiovasc Intervent Radiol. 2021 Apr;44(4):619-624. doi: 10.1007/s00270-021-02767-8. Epub 2021 Jan 20.
Cone beam CT (CBCT) with planning software is used in intra-arterial liver-directed therapies. Software accuracy relies on high CBCT image quality, which can be impaired by breathing motion. We assessed the impact of a specific MCT on software performance for procedure planning and navigation.
Institutional Review Board (IRB)-approved retrospective evaluation of liver-directed therapies from July 2015 to April 2018 was performed. CBCTs with at least one well-defined tumor and noticeable breathing motion were included. Each CBCT was reconstructed with and without breathing MCT (Motion Freeze, GE Healthcare). Automatic tumor-supplying vessel detection was performed on up to 4 tumors in each CBCT reconstruction (Liver ASSIST V.I., GE Healthcare). Vessel detection sensitivity and positive predictive value (PPV) were measured with and without MCT using Digital Subtracted Angiography (DSA) as reference. Preprocedural contrast-enhanced CT was also utilized in some cases to rule out the possibility of extrahepatic supplying vessels.
MCT was applied retrospectively to 18 CBCTs with a total of 30 tumors. At least one supplying vessel was detected for 28/30 (93%) tumors with MCT versus 20/30 (66%) without. On the subgroup of 10 CBCTs (22 tumors, 76 feeders) in which the automatic vessel detection initially worked in both reconstructions, the average sensitivity and PPV increased from 63% (48/76) and 57% (48/84) before MCT to 83% (63/76) and 79% (63/80) after (p = 0.002 and p < 0.001).
Breathing MCT improves planning software performance in CBCT impaired by breathing motion.
锥形束 CT（CBCT）与规划软件一起用于动脉内肝脏定向治疗。软件的准确性依赖于高质量的 CBCT 图像，而呼吸运动可能会降低图像质量。我们评估了特定的 MCT 对规划和导航程序软件性能的影响。
对 2015 年 7 月至 2018 年 4 月间进行的肝脏定向治疗的 CBCT 进行机构审查委员会（IRB）批准的回顾性评估。纳入至少有一个定义明确的肿瘤且有明显呼吸运动的 CBCT。每个 CBCT 均分别在有和无呼吸 MCT（GE 医疗保健公司的 Motion Freeze）的情况下进行重建。在每个 CBCT 重建中最多可对 4 个肿瘤进行自动肿瘤供血血管检测（GE 医疗保健公司的 Liver ASSIST V.I.）。使用数字减影血管造影（DSA）作为参考，分别在有和无 MCT 的情况下测量血管检测的灵敏度和阳性预测值（PPV）。在某些情况下还使用术前增强 CT 排除肝外供血血管的可能性。
18 个 CBCT（共 30 个肿瘤）被回顾性地应用 MCT。有 MCT 时，28/30（93%）个肿瘤可检测到至少一个供血血管，而无 MCT 时为 20/30（66%）个。在最初两种重建都能自动检测血管的 10 个 CBCT（22 个肿瘤，76 个供血者）亚组中，平均灵敏度和 PPV 分别从 MCT 前的 63%（48/76）和 57%（48/84）增加到 MCT 后的 83%（63/76）和 79%（63/80）（p=0.002 和 p<0.001）。
呼吸 MCT 可改善因呼吸运动而受损的 CBCT 规划软件的性能。
