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AJNR - American Journal of Neuroradiology

Publication Preview: Published September 20, 2007

American Journal of Neuroradiology 2007;28:1783.

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American Journal of Neuroradiology
DOI 10.3174/ajnr.A0637

ORIGINAL RESEARCH

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, Y. Korogi, Y. Miyaguni, J. Moriya, N. Ohnari, N. Oda, K. Nishino and W. Miyamoto

From the Department of Radiology (S.K., Y.K., Y.M., J.M., N.Oh., N.Oda), University of Occupational and Environmental Health School of Medicine, Kitakyushu, Japan; and Medical Systems Division (K.N., W.M.), 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.