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Is dual-phase C-arm CBCT sufficiently accurate for the diagnosis of colorectal cancer liver metastasis during liver intra-arterial treatment?
- Source :
-
European radiology [Eur Radiol] 2019 Oct; Vol. 29 (10), pp. 5253-5263. Date of Electronic Publication: 2019 Apr 01. - Publication Year :
- 2019
-
Abstract
- Purpose: This study aimed to estimate the accuracy of dual-phase C-arm cone beam computed tomography (CBCT) for the detection of colorectal cancer liver metastases, as compared with multidetector computed tomography (MDCT).<br />Materials and Methods: Between March 2014 and December 2016, 49 consecutive patients referred for intra-arterial treatment for colorectal cancer liver metastases were enrolled in a single-center observational study. All patients were examined with MDCT and with dual-phase C-arm cone beam computed tomography performed after iodine injection in the proper hepatic artery before intra-arterial treatment. Two blinded observers independently reviewed all examinations. Diagnostic accuracy was determined using both a six-cell matrix method and a "worst-case scenario."<br />Results: Readers identified at MDCT 264 colorectal liver metastases and 43 other liver lesions. The early and late arterial phase showed 240 and 277 liver lesions respectively. A certainty of the diagnosis was obtained in 63% and 85% at the early (EAP) and late arterial phase (LAP), respectively. Streak artifacts or liver segment truncation, or inadequate enhancement was responsible for the inability to see or to correctly adjudicate a lesion to a diagnosis in 27% and 15% of the cases at the EAP and LAP. The "worst-case scenario" yielded a Se and Sp of 58% and 51%, respectively, at EAP and 84% and 70%, respectively, at LAP.<br />Conclusion: On CBCT, EAP showed limited accuracy. LAP provided the best tumor detectability.<br />Key Points: • The early arterial phase (EAP) yielded poor accuracy: Se = 58% and Sp = 51% (p < 0.0001). • The late arterial phase (LAP) phase yielded good accuracy: Se = 84% and Se = 70% (p = 0.02). • The probability of a correct diagnosis at the EAP was 60%.
- Subjects :
- Adult
Aged
Aged, 80 and over
Cone-Beam Computed Tomography methods
Female
Hepatic Artery diagnostic imaging
Humans
Infusions, Intra-Arterial
Liver Neoplasms secondary
Liver Neoplasms therapy
Male
Middle Aged
Multidetector Computed Tomography methods
Spiral Cone-Beam Computed Tomography methods
Chemoembolization, Therapeutic methods
Colorectal Neoplasms
Liver Neoplasms diagnostic imaging
Subjects
Details
- Language :
- English
- ISSN :
- 1432-1084
- Volume :
- 29
- Issue :
- 10
- Database :
- MEDLINE
- Journal :
- European radiology
- Publication Type :
- Academic Journal
- Accession number :
- 30937583
- Full Text :
- https://doi.org/10.1007/s00330-019-06173-0