Department of Radiology, Korea University College of Medicine, Korea University Ansan Hospital, Ansan, Republic of Korea.
Department of Radiology, University of Ulsan College of Medicine, Gangneung Asan Hospital, Gangneung, Republic of Korea.
Sci Rep. 2024 Aug 6;14(1):18198. doi: 10.1038/s41598-024-69363-x.
Cone-beam computed tomography (CBCT) has proven to be a safe and effective adjunctive imaging tool for interventional radiology. Nevertheless, limited studies have examined the application of CBCT in renal artery embolization (RAE). The objective of this study is to evaluate the role of CBCT in intra-procedural decision-making for RAE. This multicenter retrospective study included 40 consecutive patients (age: 55.9 ± 16.5 years; male, 55%) who underwent CBCT during RAE from January 2019 to January 2023. The additional information provided by CBCT was classified into Category 1 (no additional information), Category 2 (more information without changing the treatment plan), and Category 3 (valuable information that led to a change in the treatment plan). CBCT did not add unique information for four patients (10%) classified as Category 1. CBCT clarified ambiguous angiographic findings and confirmed the existing treatment plan for 19 patients (47.5%) graded as Category 2; complex vascular anatomy was explained (n = 13), and a correlation between vascular territory and target lesion was established (n = 6). CBCT offered valuable information that was not visible on digital subtraction angiography and changed the treatment plan for 17 patients categorized as Category 3; a mismatch between the vascular territory and the target lesion led to the identification of alternative (n = 3) and additional feeders (n = 8); and the extent of embolization was reduced by using automatic feeder detection software (n = 6). CBCT is an efficient tool that aids in the decision-making process during the embolization procedure by providing supplementary imaging information. This additional information enables the confident identification of target vessels, facilitates superselective embolization, prevents non-target embolization, and helps locate missing feeders.
锥形束计算机断层扫描（CBCT）已被证明是介入放射学中一种安全有效的辅助成像工具。然而，有限的研究检查了 CBCT 在肾动脉栓塞（RAE）中的应用。本研究的目的是评估 CBCT 在 RAE 术中决策中的作用。这项多中心回顾性研究纳入了 2019 年 1 月至 2023 年 1 月期间在 RAE 中使用 CBCT 的 40 例连续患者（年龄：55.9±16.5 岁；男性，55%）。CBCT 提供的附加信息分为 1 类（无附加信息）、2 类（更多信息但不改变治疗计划）和 3 类（有价值的信息导致治疗计划改变）。4 名患者（10%）被归类为 1 类，CBCT 未提供独特信息。19 名患者（47.5%）被归类为 2 类，CBCT 澄清了不明确的血管造影发现并确认了现有的治疗计划；复杂的血管解剖结构得到解释（n=13），并且建立了血管区域与目标病变之间的相关性（n=6）。17 名患者（35%）被归类为 3 类，CBCT 提供了有价值的、数字减影血管造影（DSA）无法显示的信息，并改变了治疗计划；血管区域与目标病变之间不匹配导致识别出替代（n=3）和额外的供血动脉（n=8）；并且通过使用自动供血动脉检测软件减少了栓塞程度（n=6）。CBCT 是一种有效的工具，通过提供补充成像信息，有助于栓塞过程中的决策过程。这些附加信息可帮助明确目标血管，便于超选择性栓塞，防止非目标栓塞，并有助于定位缺失的供血动脉。
