Clinical impact of a new cone beam CT angiography respiratory motion artifact reduction algorithm during hepatic intra-arterial interventions
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To assess the impact of recently developed respiratory motion correction software on contrast-enhanced cone beam CT angiography (CBCT-a) for intraprocedural image guidance during intra-arterial liver-directed therapy.
From 2015 to 2017, two groups of patients who underwent intra-arterial liver-directed therapy with (breathing, n = 30) or without (still, n = 30) significant respiratory motion artifacts were retrospectively included. All CBCT-a were processed with and without dedicated respiratory motion correction software. Four readers independently assessed the following in both reconstructions (motion correction ON and OFF): (1) overall image quality on a 0-to-5 point scale, and (2) presence of relevant peri-procedural information on tumor and vasculature (overall vessel geometry, visibility of extrahepatic vessels, target tumor conspicuity, visibility of tumor feeders).
Motion correction increased the average image quality in the breathing group from 2.0 ± 0.9 to 2.9 ± 1.0 (p < 0.01). The visibility of vessel geometry, extrahepatic vessels, and tumor feeders was significantly improved for all readers, and tumor conspicuity was improved for three readers. The average image quality was not significantly different between reconstructions in the still group (motion correction ON and OFF), for any of the readers (4.0 ± 0.6 vs 4.2 ± 0.6; p = 0.12). There was no change in the visibility of vessel geometry, extrahepatic vessels, tumor feeders, or tumor conspicuity for the four readers using the respiratory motion correction software in this group.
Using the dedicated respiratory motion correction software during intra-arterial liver-directed procedures increases the visualization of relevant peri-procedural information and image quality in CBCT-a corrupted by respiratory motion artifacts without affecting these elements in still CBCT-a.
• The use of respiratory motion correction software could reduce the need for cone beam CT angiography acquisition retake.
• Motion correction software significantly increases the visibility of vessel geometry, extrahepatic vessels, and tumor feeders, as well as tumor conspicuity in cone beam CT angiography corrupted by respiratory motion artifacts.
• The use of respiratory motion correction software on cone beam CT angiography uncorrupted by respiratory motion artifact does not result in decreased image quality.
KeywordsCone beam CT Angiography Liver Chemoembolization
Cone beam computed tomography angiography
Digital subtraction angiography
Maximum intensity projection
Selective internal radiotherapy
The authors would like to thank Yves Trousset for his help on this study.
This work is part of the HECAM (HEpatocellular CArcinoma Multi-technological) consortium project and received an institutional grant from “bpifrance.”
Compliance with ethical standards
The scientific guarantor of this publication is Marco Dioguardi Burgio.
Conflict of interest
The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article.
Statistics and biometry
One of the authors has significant statistical expertise.
No complex statistical methods were necessary for this paper.
Written informed consent was waived by the Institutional Review Board.
Institutional Review Board approval was obtained.
• performed at one institution
- 4.Miyayama S, Yamashiro M, Hashimoto M et al (2013) Identification of small hepatocellular carcinoma and tumor-feeding branches with cone-beam CT guidance technology during transcatheter arterial chemoembolization. J Vasc Interv Radiol 24:501–508. https://doi.org/10.1016/j.jvir.2012.12.022 CrossRefPubMedGoogle Scholar
- 7.Lee IJ, Chung JW, Yin YH et al (2014) Cone-beam CT hepatic arteriography in chemoembolization for hepatocellular carcinoma: angiographic image quality and its determining factors. J Vasc Interv Radiol 25:1369–1379; quiz 1379-.e1. https://doi.org/10.1016/j.jvir.2014.04.011 CrossRefPubMedGoogle Scholar
- 9.Kothary N, Abdelmaksoud MH, Tognolini A et al (2011) Imaging guidance with C-arm CT: prospective evaluation of its impact on patient radiation exposure during transhepatic arterial chemoembolization. J Vasc Interv Radiol 22:1535–1543. https://doi.org/10.1016/j.jvir.2011.07.008 CrossRefGoogle Scholar
- 15.Sindel A, Bögel M, Maier A, Fahrig R, Hornegger J, Dörfler A (2015) Respiratory motion compensation for C-arm CT liver imaging. In: Handels H, Deserno TM, Meinzer HP, Tolxdorff T (eds) Bildverarbeitung für die Medizin 2015. Springer Berlin Heidelberg, Berlin, Heidelberg, pp 221–226Google Scholar