Detection of hepatocellular carcinoma feeding vessels: MDCT angiography with 3D reconstruction versus digital subtraction angiography

IF 2.9 3区医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

BMC Medical Imaging Pub Date : 2024-09-18 DOI:10.1186/s12880-024-01408-z

Ramy M. Ahmed, Wageeh A. Ali, Ahmed M. AbdelHakam, Sayed H. Ahmed

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引用次数: 0

Abstract

Accurate detection of Hepatocellular carcinoma (HCC) feeding vessels during transcatheter arterial chemoembolization (TACE) is important for an effective treatment, while limiting non-target embolization. This study aimed to investigate the feasibility and accuracy of pre-TACE three dimensional (3D) CT angiography for tumor-feeding vessels detection compared to DSA. Sixty-nine consecutive patients referred for TACE from May 2022 to May 2023 were included. (3D) CT images were reconstructed from the pre-TACE diagnostic multiphasic contrast enhanced CT images and compared with non-selective digital subtraction angiography (DSA) images obtained during TACE for detection of HCC feeding vessels. A “Ground truth” made by consensus between observers after reviewing all available pre-TACE CT images, and DSA and CBCT images during TACE to detect the true feeding vessels was the gold standard. Sensitivity, specificity, negative predictive value (NPV), positive predictive value (PPV), accuracy and ROC curve with AUC were calculated for each modality and compared. A total of 136 active HCCs were detected in the 69 consecutive patients included in the study. 185 feeding arteries were detected by 3D CT and DSA and included in the analysis. 3D CT detection of feeding arteries revealed mean sensitivity, specificity, PPV, NPV and accuracy of 91%, 71%, 98%, 36%, and 90%, respectively, with mean AUC = 0.81. DSA detection of feeding arteries revealed mean sensitivity, specificity, PPV, NPV, and accuracy of 80%, 58%, 96.5%, 16.5% and 78%, respectively, with mean AUC = 0.69. Pre-TACE 3D CT angiography has shown promise in improving the detection of HCC feeding vessels compared to DSA. However, further studies are required to confirm these findings across different clinical settings and patient populations. This study was prospectively registered at Clinicaltrials.gov with ID NCT05304572; Date of registration: 2-4-2022.

查看原文本刊更多论文

肝癌供养血管的检测：三维重建MDCT血管造影与数字减影血管造影的比较

在经导管动脉化疗栓塞术（TACE）中准确检测肝细胞癌（HCC）供血血管对有效治疗和限制非目标栓塞非常重要。本研究旨在探讨经导管动脉化疗栓塞（TACE）前三维（3D）CT血管造影与DSA相比在检测肿瘤供养血管方面的可行性和准确性。研究纳入了2022年5月至2023年5月期间转诊接受TACE的69例连续患者。(从TACE前诊断性多相对比增强CT图像重建（三维）CT图像，并与TACE期间获得的非选择性数字减影血管造影（DSA）图像进行比较，以检测HCC供养血管。观察者在审查了所有可用的 TACE 前 CT 图像以及 TACE 期间的 DSA 和 CBCT 图像后达成共识，以 "地面真实值 "为金标准来检测真正的进血管。计算并比较了每种模式的灵敏度、特异性、阴性预测值（NPV）、阳性预测值（PPV）、准确性和带有 AUC 的 ROC 曲线。在 69 名连续纳入研究的患者中，共检测出 136 个活动性 HCC。通过三维 CT 和 DSA 检测出 185 条供血动脉并纳入分析。三维 CT 检测供血动脉的平均灵敏度、特异性、PPV、NPV 和准确度分别为 91%、71%、98%、36% 和 90%，平均 AUC = 0.81。DSA 检测供血动脉的平均敏感性、特异性、PPV、NPV 和准确性分别为 80%、58%、96.5%、16.5% 和 78%，平均 AUC = 0.69。与DSA相比，TACE前三维CT血管造影有望提高HCC供血血管的检测率。然而，还需要进一步的研究在不同的临床环境和患者群体中证实这些发现。本研究已在 Clinicaltrials.gov 进行了前瞻性注册，注册号为 NCT05304572；注册日期：2-4-2022。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

BMC Medical Imaging RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING-

CiteScore

4.60

自引率

3.70%

发文量

198

审稿时长

27 weeks

期刊介绍： BMC Medical Imaging is an open access journal publishing original peer-reviewed research articles in the development, evaluation, and use of imaging techniques and image processing tools to diagnose and manage disease.