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AJNR - American Journal of Neuroradiology

Published ahead of print on September 20, 2007
doi: 10.3174/ajnr.A0637

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American Journal of Neuroradiology 28:1783-1788, October 2007
© 2007 American Society of Neuroradiology

INTERVENTIONAL

A Cone-Beam Volume CT Using a 3D Angiography System with a Flat Panel Detector of Direct Conversion Type: Usefulness for Superselective Intra-arterial Chemotherapy for Head and Neck Tumors

S. Kakeda^a, Y. Korogi^a, Y. Miyaguni^a, J. Moriya^a, N. Ohnari^a, N. Oda^a, K. Nishino^b and W. Miyamoto^b

^a Department of Radiology, University of Occupational and Environmental Health School of Medicine, Kitakyushu, Japan
^b Medical Systems Division, Shimadzu Corp, Kyoto City, Japan

Please address correspondence to Shingo Kakeda, Department of Radiology, University of Occupational and Environmental Health, 1-one Iseigaoka, Yahatanishi-ku, Kitakyushu 807-8555, Japan; e-mail: kakeda{at}med.uoeh-u.ac.jp

BACKGROUND AND PURPOSE: The development of flat panel detectors (FPDs) has made cone-beam CT feasible for practical use in a clinical setting. Our purpose was to assess the usefulness of cone-beam CT using the FPD in conjunction with conventional digital subtraction angiography (DSA) for performing superselective intra-arterial chemotherapy for head and neck tumors.

MATERIALS AND METHODS: Twenty-three consecutive patients (43 feeding arteries) were prospectively examined. All of the patients underwent intra-arterial rotational angiography using an FPD system, and the cone-beam CT was reconstructed from the volume dataset. Two radiologists evaluated the quality of the cone-beam CT and then evaluated whether the additional information provided by the cone-beam CT was useful for the interventional procedures.

RESULTS: In 41 (95%) of 43 arteries, the extent of contrast material perfusion was sufficiently visualized on cone-beam CT. In 20 (47%) of 43 arteries, the DSA plus cone-beam CT was superior to the DSA alone regarding the precise understanding of vascular territory of each artery. This information was helpful for predicting the drug delivery for superselective intra-arterial chemotherapy, especially in deeply invasive tumors with multiple feeding arteries.

CONCLUSION: In superselective intra-arterial chemotherapy for head and neck tumors, cone-beam CT with FPD provides useful additional information, which allows interventional radiologists to determine the feeders, as well as the dose of antitumor agent for each feeder.