Parenchymal Blood Volume Assessed by C-Arm–Based Computed Tomography in Immediate Posttreatment Evaluation of Drug-Eluting Bead Transarterial Chemoembolization in Hepatocellular Carcinoma

Abstract

Parenchymal blood volume values as derived from C-arm CT acquisitions in combination with nonenhanced and contrast-enhanced C-arm CT images are useful in posttreatment assessment of DEB-TACE in HCC. Residual tumor perfusion in PBV maps have predictive potential for mid-term tumor response in HCC and could allow a more individualized treatment schedule for DEB-TACE in HCC patients.

C-arm computed tomography and volume perfusion computed tomography (VPCT)-based assessment of blood volume changes in hepatocellular carcinoma in prediction of midterm tumor response to transarterial chemoembolization: a single center retrospective trial

“…Regarding perfusion parameters acquired by VPCT before and after TACE, our results yielded comparable results to previous studies evaluating TACE in HCC [ 16 , 18 ]. The same applies when comparing results of PBV measurement in HCC lesions and healthy liver parenchyma of our study to previous published data [ 10 , 13 ]. Comparing perfusion parameters acquired by VPCT and those assessed by C-arm CT (PBV) revealed some interesting additional information provided by C-arm CT, indicating an adaptation in tumor and healthy liver parenchyma to treatment.…”

“…A similar finding has recently been published concerning the assessment of PBV maps. Areas of residual increased PBV seem to be associated with an unfavorable outcome in mid-term tumor response [ 13 ]. We therefore concluded that absolute perfusion values before and after treatment might not be ideal predictors for treatment response, but ratios of perfusion parameters before and after DEB-TACE should be more appropriate for the assessment of treatment response.…”

“…Before and after delivery of DEB, a C-arm CT acquisition was performed, with the diagnostic catheter placed in the common hepatic artery, according to previous studies [ 10 , 13 ]. C-arm CT consisted of a mask non-enhanced run, a return run, and a fill run (4 s) with a gap of 2 s between the different runs (total acquisition time = 16 s).…”

Utilizing flat-panel detector parenchymal blood volume imaging (FD-PBV) for quantitative kidney perfusion analysis during the process of percutaneous transluminal renal angioplasty (PTRA)

“…[ 5 ] Shortly after this, further studies suggested baseline pre-intervention cerebral blood volume as a predictor of outcomes in patients undergoing intra-arterial stroke therapies, [ 6 ] and that this technique may substitute for multisection CT imaging to some extent in selected patients with acute stroke for the sake of saving time. [ 7 ] Apart from brain, new studies demonstrate that FD-PBV technique is useful in post-treatment assessment of transarterial chemoembolization in hepatocellular carcinoma with predictive potentials in prognosis [ 8 ] and detecting early functional response to transpulmonary chemoembolization. [ 9 ] Our preliminary data show that it could provide quantitatively assessment toward hemodynamic changes of kidney blood perfusion before and after endovascular treatment for RAS.…”

Assessment of the parenchymal blood volume by C-arm computed tomography for radioembolization dosimetry

“…C-arm CT consisted of unenhanced rotation (mask run) and contrast enhanced rotations (return and fill run) for acquisition of parenchymal blood volume (PBV) maps (time per rotation 4 s, total examination time 16 s, 90 kV, 200 • total angle, 0.8 • per frame, 248 frames, matrix 616 × 480 pixel, flat panel size 616 m, dose 0.36 Gy per frame) [7,8]. Dose area products (DAP) were documented for each C-arm CT.…”