REGULAR CONTENT
Final ID
499
Type
Original Scientific Research-Oral or Pos
Authors
P O'Connor1, E Rothenberg1, M van der Bom2, V Bishay1, R Patel1, N Tabori1, F Nowakowski1, R Lookstein1, A Fischman1, E Kim1
Institutions
1Icahn School of Medicine at Mount Sinai, New York, NY, 2Phillips Healthcare, Andover, MA
Purpose
Radiation segmentectomy (RS) with 90-Yttrium labeled glass microspheres for hepatocellular carcinoma (HCC) is performed for high radiation dose administration to maximize tumor response and minimize liver toxicity. Cone beam CT (CBCT) with 3-D segmentation and guidance software performed during planning angiography is an emerging tool for super-selective therapy delivery. Currently, assessment for satisfactory treatment delivery is performed with early post procedure MRI. This study evaluates the feasibility of predicting post-therapy radiation changes based on the planning CBCT.
Materials & Methods
A retrospective analysis of 25 patients with unresectable HCC without prior locoregional therapy who underwent planning angiography with CBCT acquisitions prior to RS was performed. Volumes of the enhanced liver segment on super-selective contrast-enhanced CBCT acquired during planning angiography, corresponding to location of drug delivery, were measured using 3D segmentation and guidance software (EmboGuide, Philips Healthcare, Netherlands). The volume of radiation changes seen on follow-up hepatobiliary phase contrast enhanced MRI (performed 4-8 weeks following therapy) was performed with standard volume analysis software (Vitrea 3D workstation, Vital Images, Plymouth, Minn). 2 radiologists performed volumetric measurements in a blinded and randomized fashion. Correlation of volume measurements between the two modalities was evaluated for statistical significance with a paired t-test.
Results
All targeted segments and tumors were completely imaged on planning CBCT and follow-up MR without evidence of non-target delivery. The mean liver segment volume of patients measured on intra-procedural CBCT and MRI showed no significant difference of overall segment measurement (93.6 mL3,112.7 SD vs. 90.9 mL3, 107.8 SD, respectively, p= 0.43).
Conclusions
Volumetric measurements from super-selective CBCT angiography during RS planning correspond well to the liver parenchymal radiation changes on follow-up MR . Utilization of 3D segmentation from the planning CBCT may be useful to predict treatment area prior to RS.
Final ID
499
Type
Original Scientific Research-Oral or Pos
Authors
P O'Connor1, E Rothenberg1, M van der Bom2, V Bishay1, R Patel1, N Tabori1, F Nowakowski1, R Lookstein1, A Fischman1, E Kim1
Institutions
1Icahn School of Medicine at Mount Sinai, New York, NY, 2Phillips Healthcare, Andover, MA
Purpose
Radiation segmentectomy (RS) with 90-Yttrium labeled glass microspheres for hepatocellular carcinoma (HCC) is performed for high radiation dose administration to maximize tumor response and minimize liver toxicity. Cone beam CT (CBCT) with 3-D segmentation and guidance software performed during planning angiography is an emerging tool for super-selective therapy delivery. Currently, assessment for satisfactory treatment delivery is performed with early post procedure MRI. This study evaluates the feasibility of predicting post-therapy radiation changes based on the planning CBCT.
Materials & Methods
A retrospective analysis of 25 patients with unresectable HCC without prior locoregional therapy who underwent planning angiography with CBCT acquisitions prior to RS was performed. Volumes of the enhanced liver segment on super-selective contrast-enhanced CBCT acquired during planning angiography, corresponding to location of drug delivery, were measured using 3D segmentation and guidance software (EmboGuide, Philips Healthcare, Netherlands). The volume of radiation changes seen on follow-up hepatobiliary phase contrast enhanced MRI (performed 4-8 weeks following therapy) was performed with standard volume analysis software (Vitrea 3D workstation, Vital Images, Plymouth, Minn). 2 radiologists performed volumetric measurements in a blinded and randomized fashion. Correlation of volume measurements between the two modalities was evaluated for statistical significance with a paired t-test.
Results
All targeted segments and tumors were completely imaged on planning CBCT and follow-up MR without evidence of non-target delivery. The mean liver segment volume of patients measured on intra-procedural CBCT and MRI showed no significant difference of overall segment measurement (93.6 mL3,112.7 SD vs. 90.9 mL3, 107.8 SD, respectively, p= 0.43).
Conclusions
Volumetric measurements from super-selective CBCT angiography during RS planning correspond well to the liver parenchymal radiation changes on follow-up MR . Utilization of 3D segmentation from the planning CBCT may be useful to predict treatment area prior to RS.