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[Image guiding techniques and navigation for TACE, SIRT and TIPS].
1Institut für Radiologie, Klinikum Nürnberg Nord, Prof.-Ernst-Nathan-Str. 1, 90419, Nürnberg, Deutschland, Adamus@klinikum-nuernberg.de.
Der Radiologe
|November 2, 2013
Summary
Cone beam CT (CBCT) enhances vessel navigation for liver tumor treatments like transarterial chemoembolization (TACE) and selective internal radiotherapy (SIRT). This technique improves accuracy in procedures such as transjugular intrahepatic portosystemic shunt (TIPS) creation.
Area of Science:
- Interventional Radiology
- Medical Imaging Technology
- Vascular Interventions
Context:
- Accurate vessel identification is crucial in liver tumor treatments like transarterial chemoembolization (TACE) and selective internal radiotherapy (SIRT) to prevent non-targeted embolization.
- Protecting extrahepatic arteries during TACE and SIRT, and precisely targeting the portal vein during transjugular intrahepatic portosystemic shunt (TIPS) creation, are critical clinical challenges.
- Current methods like digital subtraction angiography (DSA) for TACE/SIRT and ultrasound or blind puncture for TIPS have limitations in precision.
Purpose:
- To evaluate the efficacy of cone beam CT (CBCT) and 2D-3D back projection in improving vessel navigation and targeting accuracy for interventional liver procedures.
- To assess the potential of CBCT to overcome limitations of standard radiological methods in TACE, SIRT, and TIPS procedures.
- To provide evidence supporting the adoption of CBCT in routine clinical practice for enhanced procedural safety and efficacy.
Summary:
- Cone beam CT (CBCT) allows for detailed visualization of small intrahepatic vessels, surpassing the resolution of conventional digital subtraction angiography (DSA).
- The integration of 2D-3D back projection with CBCT enables precise localization of the portal vein, significantly aiding in transjugular intrahepatic portosystemic shunt (TIPS) creation.
- Utilizing CBCT and 2D-3D navigation demonstrably enhances the accuracy of vessel navigation in transarterial chemoembolization (TACE) and selective internal radiotherapy (SIRT).
Impact:
- CBCT significantly improves navigation accuracy, reducing the risk of non-targeted embolization and enhancing procedural outcomes in liver interventions.
- The adoption of CBCT technology, particularly with flat detector systems, is recommended for TACE and SIRT procedures.
- Advancements in hardware and software for 2D-3D navigation are necessary to fully leverage the benefits of CBCT in interventional radiology.
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