University Hospital "Policlinico Umberto I, Sapienza University of Rome, Rome, Italy.
Department of Interventional Radiology, University of Rome Tor Vergata, Rome, Italy.
Cardiovasc Intervent Radiol. 2023 May;46(5):635-642. doi: 10.1007/s00270-023-03420-2. Epub 2023 Apr 19.
Digital variance angiography (DVA), a recently developed image processing technology, provided higher contrast-to-noise ratio (CNR) and better image quality (IQ) during lower limb interventions than digital subtraction angiography (DSA). Our aim was to investigate whether this quality improvement can be observed also during liver transarterial chemoembolization (TACE).
We retrospectively compared the CNR and IQ parameters of DSA and DVA images from 25 patients (65% male, mean ± SD age: 67.5 ± 11.2 years) underwent TACE intervention at our institute. CNR was calculated on 50 images. IQ of every image set was evaluated by 5 experts using 4-grade Likert scales. Both single image evaluation and paired image comparison were performed in a blinded and randomized manner. The diagnostic value was evaluated based on the possibility to identify lesions and feeding arteries.
DVA provided significantly higher CNR (mean CNR/CNR was 1.33). DVA images received significantly higher individual Likert score (mean ± SEM 3.34 ± 0,08 vs. 2.89 ± 0.11, Wilcoxon signed-rank p < 0.001) and proved to be superior also in paired comparisons (median comparison score 1.60 [IQR:2.40], one sample Wilcoxon p < 0.001 compared to equal quality level). DSA could not detect lesion and feeding artery in 28 and 36% of cases, and allowed clear detection only in 22% and 16%, respectively. In contrast, DVA failed only in 8 and 18% and clearly revealed lesions and feeding arteries in 32 and 26%, respectively.
In our study, DVA provided higher quality images and better diagnostic insight than DSA; therefore, DVA could represent a useful tool in liver TACE interventions.
III Non-consecutive study.
数字减影血管造影（DSA）是一种最近开发的图像处理技术，与数字减影血管造影（DSA）相比，在下肢介入治疗中提供了更高的对比噪声比（CNR）和更好的图像质量（IQ）。我们的目的是研究这种质量提高是否也可以在肝动脉化疗栓塞（TACE）中观察到。
我们回顾性比较了我院 25 例（65%为男性，平均年龄±标准差：67.5±11.2 岁）接受 TACE 干预的患者的 DSA 和 DVA 图像的 CNR 和 IQ 参数。对 50 张图像进行了 CNR 计算。每个图像集的 IQ 由 5 名专家使用 4 级李克特量表进行评估。单张图像评估和配对图像比较均以盲法和随机方式进行。基于识别病灶和供血动脉的可能性来评估诊断价值。
DVA 提供了显著更高的 CNR（平均 CNR/CNR 为 1.33）。DVA 图像获得了显著更高的个体李克特评分（平均±SEM 3.34±0.08 与 2.89±0.11，Wilcoxon 符号秩检验 p<0.001），并且在配对比较中也表现出优越性（中位数比较评分 1.60 [IQR：2.40]，单侧样本 Wilcoxon p<0.001 与相同质量水平相比）。DSA 在 28%和 36%的病例中无法检测到病灶和供血动脉，只能分别在 22%和 16%的病例中清晰检测到。相比之下，DVA 仅在 8%和 18%的病例中失败，并且分别在 32%和 26%的病例中清晰地显示了病灶和供血动脉。
在我们的研究中，DVA 提供了比 DSA 更高质量的图像和更好的诊断效果；因此，DVA 可能成为肝 TACE 干预的有用工具。
III 非连续研究。
