Automated Feeder-Detection Software for Renal Cell Carcinoma Embolization: A Retrospective Evaluation of Detection Rate Using Transarterial Time-Resolved Computed Tomography Angiography.

Purpose: To evaluate the detection rate of feeding arteries in renal cell carcinoma with automated feeder-detection software and determine the optimal imaging phase for accurate feeder detection with transarterial time-resolved computed tomography angiography.
Materials and Methods: The performance of automated feeder-detection software was retrospectively evaluated using transarterial renal time-resolved computed tomography angiography images of 15 renal cell carcinomas (mean size, 22.1 mm); the images were obtained via the renal artery using a hybrid angio-CT system with 320-row computed tomography, across nine phases with 0.5-s intervals over a contrast delay time of 1.0-5.0 s. Automated feeder-detection software was applied to each phase in all tumors (135 image series in total). The feeder-detection rate (i.e., sensitivity) in each phase was evaluated, and the number of false feeders demonstrated by the software was counted for each tumor.
Results: A total of 22 feeders were identified. The feeder-detection rate was the highest (95.5% [21/22]) at delay times of 1.5 s and 2.0 s and lower in later phases. At delay times of 1.0 s and 1.5 s, the software demonstrated no or only a few (≤ 3) false feeders in 93.3% (14/15) of the tumors. In later phases, however, many (≥ 4) false feeders were observed in > 50% of tumors.
Conclusion: The automated feeder-detection software showed a favorable feeder-detection rate and may be useful in transarterial embolization for renal cell carcinoma. The optimal delay time to avoid the demonstration of false feeders and achieve a high detection accuracy was 1.5 s.
Level of Evidence Iv: Case Series.
(© 2023. Springer Science+Business Media, LLC, part of Springer Nature and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE).)