Accuracy of visual estimation of embolized splenic volume in N-butyl cyanoacrylate splenic embolization: Insights from a quality assurance study

This retrospective quality assurance review evaluates the concordance between visual intra-procedural angiographic estimates and CT-derived volumetric measurements of splenic embolization using n-butyl cyanoacrylate (n-BCA) with tantalum in 15 patients at a single institution. In this internal audit, 3D-Slicer software was used to segment and calculate splenic volumes from pre- and post-procedure CT scans in a series of cases where n-BCA was used for non-traumatic splenic embolization.

The median pre- and post-embolization splenic volumes were 883.32 cm³ [interquartile range (IQR) = 620.52–1234.4 cm³] and 223.68 cm³ [IQR = 34.99–555.25 cm³], respectively. The corresponding median percentage of embolized splenic parenchyma was 78.88 % [IQR = 55.51–90.88 %], compared to a median angiographic estimate of 80 % [IQR = 60–100 %] recorded in procedural documentation.

Correlation analysis between the visual angiographic estimate and volumetric calculations derived from cross-sectional CT scans showed a Pearson correlation coefficient (r) of 0.95 (p < 0.00001) and a coefficient of determination (r²) of 0.90. These findings suggest that intra-procedural visual estimates, as routinely documented by interventional radiologists at our institution, reasonably reflect the splenic embolization extent when using n-BCA.