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Impact of Multislice CT Angiography on Planning of Radiological Catheter Placement for Hepatic Arterial Infusion Chemotherapy

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Abstract

The objective of this study was to assess prospectively the role of multislice CT angiography (MSCTA) on planning of radiological catheter placement for hepatic arterial infusion chemotherapy (HAIC). Forty-six patients with malignant liver tumors planned for HAIC were included. In each patient, both MSCTA and intra-arterial digital subtraction angiography (DSA) were performed, except one patient who did not undergo DSA. Comparison of MSCTA and DSA images was performed for the remaining 45 patients. Detectability of anatomical variants of the hepatic artery, course of the celiac trunk, visualization scores of arterial branches and interobserver agreement, presence of arterial stenosis, and technical outcome were evaluated. Anatomical variations of the hepatic artery were detected in 19 of 45 patients (42%) on both modalities. The course of the celiac trunk was different in 12 patients. The visualization scores of celiac arterial branches on MSCTA/DSA were 3.0 ± 0/2.9 ± 0.2 in the celiac trunk, 3.0 ± 0/2.9 ± 0.3 in the common hepatic artery, 2.9 ± 0.2/2.9 ± 0.3 in the proper hepatic artery, 2.9 ± 0.3/2.9 ± 0.4 in the right hepatic artery, 2.8 ± 0.4/2.9 ± 0.4 in the left hepatic artery, 2.9 ± 0.2/2.9 ± 0.3 in the gastroduodenal artery, 2.1 ± 0.8/2.2 ± 0.9 in the right gastric artery, and 2.7 ± 0.8/2.6 ± 0.8 in the left gastric artery. No statistically significant differences exist between the two modalities. Interobserver agreement for MSCTA was equivalent to that for DSA. Two patients showed stenosis of the celiac trunk on both modalities. Based on these imaging findings, technical success was accomplished in all patients. In conclusion, MSCTA is accurate in assessing arterial anatomy and abnormalities. MSCTA can provide adequate information for planning of radiological catheter placement for HAIC.

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References

  1. Arai Y, Inaba Y, Takeuchi Y (1997) Interventional techniques for hepatic arterial infusion chemotherapy. In: Casterneda-Zuniga E (ed) Interventional radiology. Williams & Wilkins, Baltimore, pp 192–205

    Google Scholar 

  2. Kemeny NE, Ron IG (1999) Hepatic arterial chemotherapy in metastatic colorectal patients. Semin Oncol 26:524–535

    PubMed  CAS  Google Scholar 

  3. Tanaka T, Arai Y, Inaba Y, et al. (2003) Radiologic placement of side-hole catheter with tip fixation for hepatic arterial infusion chemotherapy. J Vasc Interv Radiol 14:63–68

    PubMed  Google Scholar 

  4. Meta-Analysis Group in Cancer (1996) Meta-Analysis Group in Cancer: reappraisal of hepatic arterial infusion in the treatment of nonresectable liver metastases from colorectal cancer. J Natl Cancer Inst 88:252–258

    Article  Google Scholar 

  5. Kemeny N, Niedzwiecki D, Hollis DR (2006) Hepatic arterial infusion versus systemic therapy for hepatic metastases from colorectal cancer: a randomized trial of efficacy, quality of life, and molecular markers (CALGB 9481). J Clin Oncol 24:1395–1403

    Article  PubMed  CAS  Google Scholar 

  6. Seki H, Kimura M, Yoshimura N, et al. (1999) Hepatic arterial infusion chemotherapy using percutaneous catheter placement with an implantable port: assessment of factors affecting patency of the hepatic artery. Clin Radiol 54:221–227

    Article  PubMed  CAS  Google Scholar 

  7. Guiney MJ, Kruskal JB, Sosna J, et al. (2003) Multi-detector row CT of relevant vascular anatomy of the surgical plane in split-liver transplantation. Radiology 229:401–407

    Article  PubMed  Google Scholar 

  8. Sahani D, Saini S, Pena C, et al. (2002) Using multidetector CT for preoperative vascular evaluation of liver neoplasms: technique and results. AJR 179:53–59

    PubMed  Google Scholar 

  9. Byun JH, Kim TK, Lee SS, et al. (2003) Evaluation of the hepatic artery in potential donors for living donor liver transplantation by computed tomography angiography using multidetector-row computed tomography: comparison of volume rendering and maximum intensity projection techniques. J Comput Assist Tomogr 27:125–131

    Article  PubMed  Google Scholar 

  10. Takahashi S, Murakami T, Takamura M, et al. (2002) Multi-detector row helical CT angiography of hepatic vessels: depiction with dual-arterial phase acquisition during single breath hold. Radiology 222:81–88

    Article  PubMed  Google Scholar 

  11. McNitt-Gray MF (2002) AAPM/RSNA physics tutorial for residents: topics in CT: radiation dose in CT. Radiographics 22:1541–1553

    Article  PubMed  Google Scholar 

  12. Erbay N, Raptopoulos V, Pomfret EA, et al. (2003) Living donor liver transplantation in adults: vascular variants important in surgical planning for donors and recipients. AJR 181:109–114

    PubMed  Google Scholar 

  13. Fishman EK (2001) From the RSNA refresher courses: CT angiography: clinical applications in the abdomen. Radiographics 21:3–16

    Google Scholar 

  14. Winter TC III, Nghiem HV, Freeny PC, et al. (1995) Hepatic arterial anatomy: demonstration of normal supply and vascular variants with three-dimensional CT angiography. Radiographics 15:771–780

    PubMed  Google Scholar 

  15. Sahani DV, Krishnamurthy SK, Kalva S, et al. (2004) Multidetector-row computed tomography angiography for planning intra-arterial chemotherapy pump placement in patients with colorectal metastases to the liver. J Comput Assist Tomogr 28:478–484

    Article  PubMed  Google Scholar 

  16. Kapoor V, Brancatelli G, Federle MP, et al. (2003) Multidetector CT arteriography with volumetric three-dimensional rendering to evaluate patients with metastatic colorectal disease for placement of a floxuridine infusion pump. AJR 181:455–463

    PubMed  Google Scholar 

  17. Yamagami T, Nakamura T, Iida S, Kato T, Nishimura T (2002) Embolization of the right gastric artery before hepatic arterial infusion chemotherapy to prevent gastric mucosal lesions: approach through the hepatic artery versus the left gastric artery. AJR 179:1605–1610

    PubMed  Google Scholar 

  18. Katoh K, Sone M, Nakasato T, et al. (2006) A new method using J-type long sheath for implantation of indwelling catheters for trans-femoral hepatic arterial infusion. Radiat Med 24:80–83

    Article  PubMed  Google Scholar 

  19. Lee VS, Morgan JN, Tan AGS, et al. (2003) Celiac artery compression by the median arcuate ligament: a pitfall of end-expiratory MR imaging. Radiology 228:437–442

    Article  PubMed  Google Scholar 

  20. Sone M, Kato K, Nakasato T, et al. (2002) Multislice CT angiography through an implantable catheter and port system: early experience in detection of vascular complications during hepatic arterial infusion chemotherapy. J Comput Assist Tomogr 26:515–519

    Article  PubMed  Google Scholar 

  21. European guidelines on quality criteria for computed tomography. Available at: http://www.drs.dk/guidelines/ct/quality/. Accessed December 12, 2006

  22. Hidajat N, Wolf M, Nunnemann A, et al. (2001) Survey of conventional and spiral CT doses. Radiology 218:395–401

    PubMed  CAS  Google Scholar 

  23. Karla MK, Maher MM, Toth TL, et al. (2004) Strategies for CT radiation dose optimization. Radiology 230:619–628

    Article  Google Scholar 

  24. Mallouhi A, Rieger M, Czermak B, et al. (2003) Volume-rendered multidetector CT angiography: noninvasive follow-up of patients treated with renal artery stents. AJR 180:233–239

    PubMed  Google Scholar 

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Acknowledgment

We are grateful to the Japanese Society of Implantable Port Assisted Regional Treatments (JSIPART) for awarding and supporting this study.

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Correspondence to Miyuki Sone.

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Sone, M., Kato, K., Hirose, A. et al. Impact of Multislice CT Angiography on Planning of Radiological Catheter Placement for Hepatic Arterial Infusion Chemotherapy. Cardiovasc Intervent Radiol 31, 91–97 (2008). https://doi.org/10.1007/s00270-007-9170-y

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  • DOI: https://doi.org/10.1007/s00270-007-9170-y

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