Impact Of C-arm CT On Hepatic Arter-Ial Chemoembolization For Hepatic Maligancies

Purpose:To evaluate C-arm computed tomography (CT) and assess its potential impact onhepatic arterial interventions.Materials And Methods:Between May2010and Mar2012, all hepatic arterial interventions for hepaticmalignancies were retrospectively reviewed. C-arm CT acquisitions were performed as anadjunct to conventional digital subtraction angiography (DSA). The number of procedureswith C-arm CT, the acquisitions per intervention, and the procedure time for allinterventions were recorded. The added information provided by C-arm CT was scored ascategory1(no additional information); category2(added information without impact onprocedure management); or category3(added information with impact on proceduremanagement). Intervention types included infusions, radioembolization, embolization, andchemoembolization. A two-sided, two-sample t test was used to compare interventionswith and without C-arm CT, and P values less than.05were considered significant.Results:C-arm CT was used in68of190interventions (36%) in121patients. The meannumber of acquisitions per study was1.9(range,1–4). Twenty-eight interventions (40.7%)were scored as category2and13interventions (18.6%) were scored as category3.Chemoembolization was associated with the highest percentage of C-arm CTinvestigations classified as category2and3assessed per intervention. The mean proceduretime was significantly longer (18minutes) when C-arm CT was used (P <.001).Conclusions:C-arm CT provides additional imaging information beyond DSA during hepaticarterial interventions (approximately60%), and this information impacted proceduremanagement in19%of cases. C-arm CT offers the greatest opportunity for additionalinformation during chemoembolization procedures and is responsible for a significant but acceptable increase in procedure time for this type of hepatic intervention.