scholarly journals Imaging Artifacts of Nonadhesive Liquid Embolic Agents in Conventional and Cone-beam CT in a Novel in Vitro AVM Model

Author(s):  
Niclas Schmitt ◽  
Ralf O Floca ◽  
Daniel Paech ◽  
Rami A El Shafie ◽  
Ulf Neuberger ◽  
...  

Abstract Background A major drawback of liquid embolic agents (LEAs) is the generation of imaging artifacts (IA), which may represent a crucial obstacle for the detection of periprocedural hemorrhage or subsequent radiosurgery of cerebral arteriovenous malformations (AVMs). This study aimed to compare the IAs of Onyx, Squid and PHIL in a novel three-dimensional in vitro AVM model in conventional computed tomography (CT) and cone-beam CT (CBCT). Methods Tubes with different diameters were configured in a container resembling an AVM with an artificial nidus at its center. Subsequently, the AVM models were filled with Onyx 18, Squid 18, PHIL 25% or saline and inserted into an imaging phantom (n = 10/LEA). Afterwards CT and CBCT scans were acquired. The degree of IAs was graded quantitatively (Hounsfield units in a defined region of interest) and qualitatively (feasibility of defining the nidus)—Onyx vs. Squid vs. PHIL vs. saline, respectively. Results Quantitative density evaluation demonstrated more artifacts for Onyx compared to Squid and PHIL, e.g. 48.15 ± 14.32 HU for Onyx vs. 7.56 ± 1.34 HU for PHIL in CT (p < 0.001) and 41.88 ± 7.22 density units (DU) for Squid vs. 35.22 ± 5.84 DU for PHIL in CBCT (p = 0.044). Qualitative analysis showed less artifacts for PHIL compared to Onyx and Squid in both imaging modalities while there was no difference between Onyx and Squid regarding the definition of the nidus (p > 0.999). Conclusion In this novel three-dimensional in vitro AVM model, IAs were higher for the EVOH/tantalum-based LEAs Onyx and Squid compared to iodine-based PHIL. Onyx induced the highest degree of IAs with only minor differences to Squid.

2018 ◽  
Vol 24 (6) ◽  
pp. 693-701 ◽  
Author(s):  
Dominik F Vollherbst ◽  
Ruth Otto ◽  
Thuy Do ◽  
Hans U Kauczor ◽  
Martin Bendszus ◽  
...  

Background and purpose A frequently reported drawback of ethylene vinyl alcohol copolymer-based liquid embolic agents is the production of artifacts in diagnostic imaging. New embolic agents, such as Precipitating hydrophobic injectable liquid (PHIL; MicroVention, Tustin, CA, USA), are supposed to induce significantly fewer artifacts. The purpose of this study is to assess the degree of artifacts induced by the liquid embolic agents Onyx (Medtronic Neurovascular, Irvine, CA, USA) and PHIL in conventional computed tomography (CT), cone-beam CT and magnetic resonance imaging (MRI) in an experimental in vivo model. Materials and methods In 10 pigs the rete mirabile was embolized with Onyx ( n = 5) or PHIL ( n = 5). After embolization, conventional CT, cone-beam CT and MRI were performed. The degree of artifacts was graded qualitatively (five-point scale; for CT and MRI) and quantitatively (HUs of well-defined regions of interest (ROIs); for CT only). Results Artifacts were significantly more severe for Onyx both in the qualitative (e.g. conventional CT: 2 versus 5 (medians); p = 0.008) and in the quantitative image analysis (e.g. cone-beam CT: standard deviation of a ROI near to the embolic agent cast, 94 HU versus 38 HU (medians); p = 0.008). Neither Onyx nor PHIL produced any apparent artifacts in MRI. Conclusion PHIL produces fewer artifacts than Onyx in conventional CT and cone-beam CT in an experimental in vivo model.


2020 ◽  
Vol 42 (1) ◽  
pp. 126-131
Author(s):  
N. Schmitt ◽  
R.O. Floca ◽  
D. Paech ◽  
R.A. El Shafie ◽  
F. Seker ◽  
...  

Author(s):  
H. Bertin ◽  
R. Bonnet ◽  
M. Anquetil ◽  
A.S. Delemazure ◽  
E. Mourrain-Langlois ◽  
...  

2020 ◽  
Vol 49 (4) ◽  
pp. 20190402
Author(s):  
Junliang Chen ◽  
Dongmei Lv ◽  
MingXia Li ◽  
Wei Zhao ◽  
Yun He

This study aimed to reveal the correlation between the radiolucency area around the crown of impacted maxillary canines and dentigerous cysts using cone beam CT (CBCT). CBCT data were obtained from patients with impacted maxillary canines. Three points of five areas (tooth cusp area and buccal, lingual, mesial and distal areas of the crown) were randomly selected, and the distance between the point and the surrounding hard tissue was measured respectively. The mean values were recorded as the radiolucency area. These results were compared with the occurrence of dentigerous cysts during surgery. 58 patients with 76 impacted maxillary canines were included. 14 of the 76 impacted canines were accompanied by cysts (18.42%). With the increase in the thickness of the radiolucency area, the incidence of cysts was significantly increased (p < 0.05). No cysts were found in the compacted canines with 0–1 mm thickness of the radiolucency area. The highest incidence (71.43%) was observed in canines with 3–4 mm thickness of the radiolucency area. This study found that the thickness of the radiolucency area around the crown of the maxillary impacted canine was closely related to the occurrence of dentigerous cysts. CBCT can be used to estimate the occurrence possibility of dentigerous cyst and guide surgical operations.


2009 ◽  
Vol 20 (7) ◽  
pp. S523-S537 ◽  
Author(s):  
Michael J. Wallace ◽  
Michael D. Kuo ◽  
Craig Glaiberman ◽  
Christoph A. Binkert ◽  
Robert C. Orth ◽  
...  

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