|Title:||Assessing vascularity of osseous spinal metastases with dual-energy CT-DSA: A pilot study compared with catheter angiography||Authors:||Huang Y.-C.
|Issue Date:||2019||Journal Volume:||40||Journal Issue:||5||Start page/Pages:||920-925||Source:||American Journal of Neuroradiology||Abstract:||
BACKGROUND AND PURPOSE: Spine debulking surgery in patients with hypervascular spinal metastasis is associated with massive intraoperative blood loss, but currently, the vascularity of tumor is determined by invasive conventional angiography or dynamic contrast MR imaging. We aimed to investigate the usefulness of noninvasive dual-energy CT-DSA, comparing it with conventional angiography in evaluating the vascularity of spinal metastasis. MATERIALS AND METHODS: We conducted a retrospective study from January to December 2018. A total of 15 patients with spinal metastasis undergoing dual-energy CT, conventional DSA, and subsequent debulking surgery were included. CT-DSA images were produced after rigid-body registration and subtraction between CT phases. Qualitative and quantitative assessments of tumor vascularity were conducted. Correlations between CT-DSA and conventional DSA results were evaluated using the Spearman coefficient. The mean enhancement in the estimated tumor volume and surgical blood loss was compared between hypervascular and nonhypervascular groups using the Wilcoxon rank sum test. RESULTS: The CT-DSA and DSA results were strongly correlated, with ρ = 0.87 (P < .001). The DSA and the quantitative enhancement index also showed a strong correlation with ρ = 0.83 (P < .001). Wilcoxon rank sum testing between hypervascular and nonhypervascular CT-DSA groups showed a difference in enhancement indices (P=.0003). The blood loss between the hypervascular and nonhypervascular groups was nonsignificant (P = .09). CONCLUSIONS: Dual-energy CT-DSA correlates well with conventional DSA in assessing the vascularity of spinal metastasis. It may serve as a noninvasive preoperative evaluation option before debulking surgery. ? 2019 American Society of Neuroradiology. All rights reserved.
|URI:||https://scholars.lib.ntu.edu.tw/handle/123456789/512776||ISSN:||0195-6108||DOI:||10.3174/ajnr.A6023||SDG/Keyword:||adult; aged; Article; artificial embolization; cancer surgery; clinical article; conventional angiography; cytoreductive surgery; dual energy X ray absorptiometry; female; human; image enhancement; intermethod comparison; male; middle aged; operative blood loss; pilot study; qualitative analysis; quantitative analysis; retrospective study; spinal angiography; spinal cord metastasis; tumor localization; tumor vascularization; tumor volume; diagnostic imaging; digital subtraction angiography; operative blood loss; procedures; spine tumor; vascularization; x-ray computed tomography; Adult; Aged; Angiography, Digital Subtraction; Blood Loss, Surgical; Female; Humans; Male; Middle Aged; Pilot Projects; Radiographic Image Enhancement; Retrospective Studies; Spinal Neoplasms; Tomography, X-Ray Computed
|Appears in Collections:||醫學院附設醫院 (臺大醫院)|
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