Detection of the Origin of the Cystic Artery during Transcatheter Arterial Embolization of Hepatocellular Carcinomas: Comparison of Cone Beam CT and Digital Subtraction Angiography
In this study, we retrospectively compared the usefulness of cone beam CT (CBCT) with that of digital subtraction angiography (DSA) in the identification of the origin of the cystic artery during arterial embolization for hepatocellular carcinoma. Subjects were sixty-four patients who underwent tran...
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| Published in | The Showa University Journal of Medical Sciences Vol. 21; no. 2; pp. 85 - 93 |
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| Main Authors | , , , , |
| Format | Journal Article |
| Language | English |
| Published |
The Showa University Society
2009
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| Subjects | |
| Online Access | Get full text |
| ISSN | 0915-6380 2185-0968 |
| DOI | 10.15369/sujms.21.85 |
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| Abstract | In this study, we retrospectively compared the usefulness of cone beam CT (CBCT) with that of digital subtraction angiography (DSA) in the identification of the origin of the cystic artery during arterial embolization for hepatocellular carcinoma. Subjects were sixty-four patients who underwent transcatheter arterial embolization (TAE) for hepatocellular carcinoma, in whom both CBCT and DSA were performed. Two radiologists independently examined CBCT and DSA images, and attempted to identify the origin of the cystic artery in each image. For DSA, en face views were reviewed on the monitor. For CBCT, 5 mm thick horizontal sections were generated using Workstation software, and the MPR method was used for coronary sections. These were then investigated with OsiriX. Of the sixty-four patients, the cystic arterial origin could be identified using DSA in 21 (32.8%) and CBCT in 62 (96.8%). The cystic artery was shown to originate in the proper, right, middle, and left hepatic artery in one, 58, two, and one patient, respectively. These results show that CBCT was more useful than DSA for identifying cystic arterial origin. Therefore CBCT should be positively applied during TAE. |
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| AbstractList | In this study, we retrospectively compared the usefulness of cone beam CT (CBCT) with that of digital subtraction angiography (DSA) in the identification of the origin of the cystic artery during arterial embolization for hepatocellular carcinoma. Subjects were sixty-four patients who underwent transcatheter arterial embolization (TAE) for hepatocellular carcinoma, in whom both CBCT and DSA were performed. Two radiologists independently examined CBCT and DSA images, and attempted to identify the origin of the cystic artery in each image. For DSA, en face views were reviewed on the monitor. For CBCT, 5 mm thick horizontal sections were generated using Workstation software, and the MPR method was used for coronary sections. These were then investigated with OsiriX. Of the sixty-four patients, the cystic arterial origin could be identified using DSA in 21 (32.8%) and CBCT in 62 (96.8%). The cystic artery was shown to originate in the proper, right, middle, and left hepatic artery in one, 58, two, and one patient, respectively. These results show that CBCT was more useful than DSA for identifying cystic arterial origin. Therefore CBCT should be positively applied during TAE. |
| Author | HONDA, Minoru HASHIMOTO, Toshi SEINO, Noritaka HASHIZUME, Takashi GOKAN, Takehiko |
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| References | 19) Kakeda S, Korogi Y, Hatakeyama Y, Ohnari N, Oda N, Nishino K and Miyamoto W: The Usefulness of three-dimensional angiography with a flat panel detector of direct conversion type in a transcatheter arterial chemoembolization procedure for hepatocellular carcinoma: initial experience. Cardiovasc Intervent Radiol 31: 281-288 (2008 4) Hirakawa M, Iida M, Aoyagi K, Matsui T, Akagi K and Fujishima M: Gastroduodenal lesions after transcatheter arterial chemoembolization in patients with hepatocellular carcinoma. Am J Gastroenterol 83: 837-840 (1988 5) Sakamoto I, Aso N, Nagaoki K, Matsuoka Y, Uetani M, Ashizawa K, Iwanaga S, Mori M, Morikawa M, Fukuda T, Hayashi K and Matsunaga N: Complications associated with transcatheter arterial embolization for hepatic tumors. Radiographics 18: 605-619 (1998 1) Takano H: From 3DCT to flat-detector angiographic CT (FACT: Dyna CT) : initial clinical experiences. Jpn J Tomogr 33: 118-125 (2006) (in Japanese 10) Jacob ET, Shapira Z, Morag B and Rubinstein Z: Hepatic infarction and gallbladder necrosis complicating arterial embolization for bleeding duodenal ulcer. Dig Dis Sci 24: 482-484 (1979 13) Kobayashi T, Suzuki E, Yoshida S, Ito A and Ikeda H: A gall bladder search by the angiography. Surg Ther 29: 372-377 (1973) (in Japanese 7) Takayasu K, Moriyama N, Muramatsu Y, Shima Y, Ushio K, Yamada T, Kishi K and Hasegawa H: Gallbladder infarction after hepatic artery embolization. Am J Roentgenol 144: 135-138 (1985 20) Sugita R, Yamazaki T, Fujita N, Naitoh T, Kobari M and Takahashi S: Cystic artery and cystic duct assessment with 64-detector row CT before laparoscopic cholecystectomy. Radiology 248: 124-131 (2008 16) Michels NA: Blood Supply and Anatomy of the Upper Abdominal Organs. Lippincott, Philadelphia (1955 12) Sato M, Watanabe K, Saitou Y and Koyama K: Diagnostic value of arteriography in gallbladder disease. Jpn J Clin Radiol 13: 605-612 (1968) (in Japanese 3) Hashimoto T, Seino N, Honda M, Hayano D, Hashizume T, Oogiya Y, Hirose M and Gokan T: Interventional C-arm CT “ Dyna CT”. Innervision 22: 44-47 (2007) (in Japanese 9) Hori S, Isaza M, Marukawa T, Hosoki T, Tokunaga K, Yoshioka H, Kuroda C, Kozuka T, Monden M and Sakurai M: A new CT sign of gallbladder infarction following hepatic arterial embolization. Partial enhancement of gallbladder wall. Nippon Acta Radiol 47: 1542-1549 (1987) (in Japanese 11) Okamura J, Horikawa S, Fujiyama T, Monden M, Kambayashi J, Sikujara O, Sakurai M, Kuroda C, Nakamura H and Kosaki G: An appraisal of transcatheter arterial embolization combined with transcatheter arterial infusion of chemotherapeutic agent for hepatic malignancies. World J Surg 6: 352-357 (1982 17) Lipschtz B: A composite study of the celiac axis artery. Ann Surg 65: 159-169 (1917 15) Naruto K: Angiographic observation of cystic artery, especially on the variations in origin and size. Nippon Acta Radiol 40: 529-546 (1980) (in Japanese 2) Hashimoto T, Seino N, Honda M, Hashizume T, Shinjo H, Oogiya Y and Gokan T: Flat detector C-arm CT for interventional radiology: new development with Dyna CT. Jpn J Tomogr 33: 126-133 (2006) (in Japanese 8) Ueno S, Yamashita Y, Nishimura R, Bussaka H, Miyawaki M, Fukui K and Takahashi M: Gallbladder abnormalities following transcatheter arterial embolization of hepatic malignancies. Nippon Acta Radiol 46: 1379-1386 (1986) (in Japanese 18) Daseler EH, Anson BJ, Hambley WC and Reimann AF: The cystic artery and constituents of the hepatic pedicle. Surg Gynecol Obstet 85: 47-63 (1947 6) Kuroda C, Iwasaki M, Tanaka T, Tokunaga K, Hori S, Yoshioka H, Nakamura H, Sakurai M and Okamura J: Gallbladder infarction following hepatic transcatheter arterial embolization: angiographic study. Radiology 149: 85-89 (1983 14) Takashima R and Sin M: Evaluation of cystic artery with angiography. Intern Med 27: 647-655 (1971) (in Japanese |
| References_xml | – reference: 9) Hori S, Isaza M, Marukawa T, Hosoki T, Tokunaga K, Yoshioka H, Kuroda C, Kozuka T, Monden M and Sakurai M: A new CT sign of gallbladder infarction following hepatic arterial embolization. Partial enhancement of gallbladder wall. Nippon Acta Radiol 47: 1542-1549 (1987) (in Japanese) – reference: 12) Sato M, Watanabe K, Saitou Y and Koyama K: Diagnostic value of arteriography in gallbladder disease. Jpn J Clin Radiol 13: 605-612 (1968) (in Japanese) – reference: 14) Takashima R and Sin M: Evaluation of cystic artery with angiography. Intern Med 27: 647-655 (1971) (in Japanese) – reference: 1) Takano H: From 3DCT to flat-detector angiographic CT (FACT: Dyna CT) : initial clinical experiences. Jpn J Tomogr 33: 118-125 (2006) (in Japanese) – reference: 8) Ueno S, Yamashita Y, Nishimura R, Bussaka H, Miyawaki M, Fukui K and Takahashi M: Gallbladder abnormalities following transcatheter arterial embolization of hepatic malignancies. Nippon Acta Radiol 46: 1379-1386 (1986) (in Japanese) – reference: 3) Hashimoto T, Seino N, Honda M, Hayano D, Hashizume T, Oogiya Y, Hirose M and Gokan T: Interventional C-arm CT “ Dyna CT”. Innervision 22: 44-47 (2007) (in Japanese) – reference: 6) Kuroda C, Iwasaki M, Tanaka T, Tokunaga K, Hori S, Yoshioka H, Nakamura H, Sakurai M and Okamura J: Gallbladder infarction following hepatic transcatheter arterial embolization: angiographic study. Radiology 149: 85-89 (1983) – reference: 10) Jacob ET, Shapira Z, Morag B and Rubinstein Z: Hepatic infarction and gallbladder necrosis complicating arterial embolization for bleeding duodenal ulcer. Dig Dis Sci 24: 482-484 (1979) – reference: 15) Naruto K: Angiographic observation of cystic artery, especially on the variations in origin and size. Nippon Acta Radiol 40: 529-546 (1980) (in Japanese) – reference: 16) Michels NA: Blood Supply and Anatomy of the Upper Abdominal Organs. Lippincott, Philadelphia (1955) – reference: 7) Takayasu K, Moriyama N, Muramatsu Y, Shima Y, Ushio K, Yamada T, Kishi K and Hasegawa H: Gallbladder infarction after hepatic artery embolization. Am J Roentgenol 144: 135-138 (1985) – reference: 19) Kakeda S, Korogi Y, Hatakeyama Y, Ohnari N, Oda N, Nishino K and Miyamoto W: The Usefulness of three-dimensional angiography with a flat panel detector of direct conversion type in a transcatheter arterial chemoembolization procedure for hepatocellular carcinoma: initial experience. Cardiovasc Intervent Radiol 31: 281-288 (2008) – reference: 18) Daseler EH, Anson BJ, Hambley WC and Reimann AF: The cystic artery and constituents of the hepatic pedicle. Surg Gynecol Obstet 85: 47-63 (1947) – reference: 4) Hirakawa M, Iida M, Aoyagi K, Matsui T, Akagi K and Fujishima M: Gastroduodenal lesions after transcatheter arterial chemoembolization in patients with hepatocellular carcinoma. Am J Gastroenterol 83: 837-840 (1988) – reference: 5) Sakamoto I, Aso N, Nagaoki K, Matsuoka Y, Uetani M, Ashizawa K, Iwanaga S, Mori M, Morikawa M, Fukuda T, Hayashi K and Matsunaga N: Complications associated with transcatheter arterial embolization for hepatic tumors. Radiographics 18: 605-619 (1998) – reference: 20) Sugita R, Yamazaki T, Fujita N, Naitoh T, Kobari M and Takahashi S: Cystic artery and cystic duct assessment with 64-detector row CT before laparoscopic cholecystectomy. Radiology 248: 124-131 (2008) – reference: 2) Hashimoto T, Seino N, Honda M, Hashizume T, Shinjo H, Oogiya Y and Gokan T: Flat detector C-arm CT for interventional radiology: new development with Dyna CT. Jpn J Tomogr 33: 126-133 (2006) (in Japanese) – reference: 13) Kobayashi T, Suzuki E, Yoshida S, Ito A and Ikeda H: A gall bladder search by the angiography. Surg Ther 29: 372-377 (1973) (in Japanese) – reference: 17) Lipschtz B: A composite study of the celiac axis artery. Ann Surg 65: 159-169 (1917) – reference: 11) Okamura J, Horikawa S, Fujiyama T, Monden M, Kambayashi J, Sikujara O, Sakurai M, Kuroda C, Nakamura H and Kosaki G: An appraisal of transcatheter arterial embolization combined with transcatheter arterial infusion of chemotherapeutic agent for hepatic malignancies. World J Surg 6: 352-357 (1982) |
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| Title | Detection of the Origin of the Cystic Artery during Transcatheter Arterial Embolization of Hepatocellular Carcinomas: Comparison of Cone Beam CT and Digital Subtraction Angiography |
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