Magnetic Resonance-Digital Subtraction Angiography as a Preprocedural Imaging Modality before Transcatheter Arterial...

Area of Science:

• Radiology
• Interventional Radiology
• Musculoskeletal Imaging

Background:

• Transcatheter arterial microembolization (TAME) is used for musculoskeletal pain management.
• Conventional digital subtraction angiography (DSA) is the standard preprocedural imaging modality.
• The accuracy and utility of alternative imaging techniques require evaluation.

Purpose of the Study:

• To compare the accuracy of magnetic resonance (MR)-digital subtraction angiography (MR-DSA) with conventional DSA.
• To evaluate MR-DSA as a preprocedural imaging tool for TAME in musculoskeletal pain.
• To assess the correlation between imaging findings and pain reduction.

Main Methods:

• Retrospective evaluation of 11 patients undergoing MR-DSA and DSA before TAME.
• Three experienced readers assessed abnormal vascular enhancement on a 4-point scale.
• Sensitivity, specificity, and interobserver agreement were calculated.
• Pain scores (Numerical Rating Scale) were recorded before and after TAME.

Main Results:

• Interobserver agreement was substantial for both DSA (κ=0.66) and MR-DSA (κ=0.73).
• MR-DSA demonstrated high sensitivity (1.0) and moderate specificity (0.64) compared to DSA.
• A mean pain reduction of 2.6 points on the NRS was observed post-TAME.

Conclusions:

• MR-DSA is a highly sensitive method for detecting abnormal vascular enhancement in musculoskeletal pain.
• Its definitive clinical utility for TAME requires further investigation.
• Larger studies are necessary to establish MR-DSA's role in preprocedural planning.