Value of Latest-generation Cone-beam Computed Tomography for Post Lipiodol-embolization Imaging in Hepatic Transarterial Chemoembolization in Comparison with Multi-detector Computed Tomography

Author(s):  
Leona S. Alizadeh ◽  
Vitali Koch ◽  
Thomas J. Vogl ◽  
Ibrahim Yel ◽  
Leon Gruenewald ◽  
...  
2021 ◽  
Author(s):  
P.L.E. Oliveira ◽  
C.R. Starling ◽  
C.L.P. Maurício ◽  
F.R. Guedes ◽  
M.A. Visconti ◽  
...  

Introduction: The objective of this study was to compare the mean absorbed dose in patients undergoing head and neck examinations using two cone beam computed tomography (CBCT, Kodak and i-CAT) and one multi-detector computed tomography (MDCT). Methods: Three thermoluminescent dosimeters (TLDs), calibrated in air kerma, were positioned in 24 regions of the head and neck of a phantom simulating an average adult. The mean absorbed dose (mGy) values in these positions, for different organs and tissues, were obtained using correction factors, considering the ratio between the mass energy absorption coefficients of organ/tissue and air. Comparison between radiation doses in the most radiosensitive regions was done by calculating the ratio of these dose values, with propagated uncertainty. Results: The dose in all regions was significantly higher for MDCT when compared to CBCT. Concerning CBCT equipment, the Kodak device had a higher absorbed dose than the i-CAT for most of the regions tested. The uncertainty of the i-CAT was greater than that of the Kodak. Conclusion: Due to the considerable difference between absorbed doses, emphasizing the higher dose values obtained in MDCT, the dissemination of CBCT application in medicine is recommended, as well as further studies to broaden the criteria for use.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Kittipitch Bannangkoon ◽  
Keerati Hongsakul ◽  
Teeravut Tubtawee

Abstract Background Inoperable hepatocellular carcinoma (HCC) is treated by conventional transarterial chemoembolization (cTACE) using cone-beam computed tomography (CBCT) or digital subtraction angiography (DSA). We compared patient survival outcomes between CBCT-cTACE with automated tumor-feeder detection (AFD) software and DSA-cTACE alone in inoperable HCC patients. Methods We reviewed the data of 337 HCC patients treated by CBCT-cTACE or DSA-cTACE between January 2015 and December 2019. Treatment response, progression-free survival (PFS), overall survival (OS), and complications between the CBCT-cTACE and DSA-cTACE groups were compared. Univariate and multivariate logistic regression analyses examined the potential prognostic factors affecting survival after chemoembolization. Results Tumor response rates in complete response, partial response, and stable disease at 1 month were 67%, 28%, and 4% in the CBCT-cTACE group and 22%, 48%, and 9% in the DSA-cTACE group, respectively. OS rates of patients in the CBCT-cTACE versus DSA-cTACE groups were 87% versus 54%, 44% versus 15%, and 34% versus 7% at 1, 3, and 5 years, respectively. The CBCT-cTACE group had significantly improved PFS (p < 0.001) and OS (p < 0.001). Multivariate analysis showed that CBCT with AFD software was an independent factor associated with longer OS (hazard ratio, 0.38; p < 0.001). Conclusions Compared with conventional DSA, combining selective cTACE with CBCT and AFD software leads to better tumor response and prolongs OS in patients with inoperable HCC.


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