A Quantitative Digital Subtraction Angiography Technique for Characterizing Reduction in Hepatic Arterial Blood Flow During Transarterial Embolization
Objective There is no standardized and objective method for determining the optimal treatment endpoint (sub-stasis) during transarterial embolization. The objective of this study was to demonstrate the feasibility of using a quantitative digital subtraction angiography (qDSA) technique to characteri...
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| Veröffentlicht in: | Cardiovascular and interventional radiology 2021-02, Vol.44 (2), p.310-317 |
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| creator | Periyasamy, Sarvesh Hoffman, Carson A. Longhurst, Colin Schefelker, Georgia C. Ozkan, Orhan S. Speidel, Michael A. Laeseke, Paul F. |
| description | Objective
There is no standardized and objective method for determining the optimal treatment endpoint (sub-stasis) during transarterial embolization. The objective of this study was to demonstrate the feasibility of using a quantitative digital subtraction angiography (qDSA) technique to characterize intra-procedural changes in hepatic arterial blood flow velocity in response to transarterial embolization in an in vivo porcine model.
Materials and Methods
Eight domestic swine underwent bland transarterial embolizations to partial- and sub-stasis angiographic endpoints with intraprocedural DSA acquisitions. Embolized lobes were assessed on histopathology for ischemic damage and tissue embolic particle density. Analysis of target vessels used qDSA and a commercially available color-coded DSA (ccDSA) tool to calculate blood flow velocities and time-to-peak, respectively.
Results
Blood flow velocities calculated using qDSA showed a statistically significant difference (
p
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| doi_str_mv | 10.1007/s00270-020-02640-0 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_7855448</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2449179991</sourcerecordid><originalsourceid>FETCH-LOGICAL-c474t-31e3ce5308acf5b49eecf7d5567cb58b4a486a05270b0f71de3bf5efd43eb0633</originalsourceid><addsrcrecordid>eNp9kc1u1DAUhS0EokPhBVggS2zYBOzYjpMN0jBtKVIlBAwSO8txbjKuMnZqJ0Xtg_R565C2_CxY-Ee63z32PQehl5S8pYTId5GQXJKM5PMqeNofoRXlLM9IWfx4jFaESp5RIegBehbjOSFUlLl4ig4YI7nIOV-hmzX-Mmk32lGP9hLwke3StcffpnoM2ozWO7x2nfVd0MPuCm_B7Jy9mAC3PuDNTs8QBHttXYe_QjMtLdbhUxiSpMHrMNeT5Ife-waf9P4nPprCzG-DdlHf14_3te_ttZ4FnqMnre4jvLg7D9H3k-Pt5jQ7-_zx02Z9lhku-ZgxCsyAYKTUphU1rwBMKxshCmlqUdZc87LQRCSbatJK2gCrWwFtwxnUpGDsEL1fdIep3kNjwKWpezUEu9fhSnlt1d8VZ3eq85dKlkJwXiaBN3cCwSdX4qj2Nhroe-3AT1Elkysqq6qiCX39D3rup-DSeImSkpU5FyJR-UKZ4GMM0D58hhI1x66W2FWKXf2KXZHU9OrPMR5a7nNOAFuAOMzOQ_j99n9kbwGFwryy</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2477382455</pqid></control><display><type>article</type><title>A Quantitative Digital Subtraction Angiography Technique for Characterizing Reduction in Hepatic Arterial Blood Flow During Transarterial Embolization</title><source>MEDLINE</source><source>SpringerLink Journals - AutoHoldings</source><creator>Periyasamy, Sarvesh ; Hoffman, Carson A. ; Longhurst, Colin ; Schefelker, Georgia C. ; Ozkan, Orhan S. ; Speidel, Michael A. ; Laeseke, Paul F.</creator><creatorcontrib>Periyasamy, Sarvesh ; Hoffman, Carson A. ; Longhurst, Colin ; Schefelker, Georgia C. ; Ozkan, Orhan S. ; Speidel, Michael A. ; Laeseke, Paul F.</creatorcontrib><description>Objective
There is no standardized and objective method for determining the optimal treatment endpoint (sub-stasis) during transarterial embolization. The objective of this study was to demonstrate the feasibility of using a quantitative digital subtraction angiography (qDSA) technique to characterize intra-procedural changes in hepatic arterial blood flow velocity in response to transarterial embolization in an in vivo porcine model.
Materials and Methods
Eight domestic swine underwent bland transarterial embolizations to partial- and sub-stasis angiographic endpoints with intraprocedural DSA acquisitions. Embolized lobes were assessed on histopathology for ischemic damage and tissue embolic particle density. Analysis of target vessels used qDSA and a commercially available color-coded DSA (ccDSA) tool to calculate blood flow velocities and time-to-peak, respectively.
Results
Blood flow velocities calculated using qDSA showed a statistically significant difference (
p
< 0.01) between partial- and sub-stasis endpoints, whereas time-to-peak calculated using ccDSA did not show a significant difference. During the course of embolizations, the average correlation with volume of particles delivered was larger for qDSA (− 0.86) than ccDSA (0.36). There was a statistically smaller mean squared error (
p
< 0.01) and larger coefficient of determination (
p
< 0.01) for qDSA compared to ccDSA. On pathology, the degree of embolization as calculated by qDSA had a moderate, positive correlation (
p
< 0.01) with the tissue embolic particle density of ischemic regions within the embolized lobe.
Conclusions
qDSA was able to quantitatively discriminate angiographic embolization endpoints and, compared to a commercially available ccDSA method, improve intra-procedural characterization of blood flow changes. Additionally, the qDSA endpoints correlated with tissue-level changes.</description><identifier>ISSN: 0174-1551</identifier><identifier>EISSN: 1432-086X</identifier><identifier>DOI: 10.1007/s00270-020-02640-0</identifier><identifier>PMID: 33025244</identifier><language>eng</language><publisher>New York: Springer US</publisher><subject>Angiography ; Angiography, Digital Subtraction - methods ; Animals ; Blood flow ; Blood Flow Velocity - physiology ; Cardiology ; Chemoembolization ; Correlation ; Embolisation (arterial) ; Embolization ; Embolization, Therapeutic - methods ; Evaluation Studies as Topic ; Feasibility Studies ; Flow velocity ; Hepatic Artery - diagnostic imaging ; Hepatic Artery - physiopathology ; Histopathology ; Imaging ; In vivo methods and tests ; Ischemia ; Laboratory Investigation ; Liver ; Liver cancer ; Livestock ; Medical imaging ; Medicine ; Medicine & Public Health ; Nuclear Medicine ; Particle density (concentration) ; Radiology ; Statistical analysis ; Swine ; Tissue analysis ; Tissues ; Ultrasound</subject><ispartof>Cardiovascular and interventional radiology, 2021-02, Vol.44 (2), p.310-317</ispartof><rights>Springer Science+Business Media, LLC, part of Springer Nature and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE) 2020</rights><rights>Springer Science+Business Media, LLC, part of Springer Nature and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE) 2020.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c474t-31e3ce5308acf5b49eecf7d5567cb58b4a486a05270b0f71de3bf5efd43eb0633</citedby><cites>FETCH-LOGICAL-c474t-31e3ce5308acf5b49eecf7d5567cb58b4a486a05270b0f71de3bf5efd43eb0633</cites><orcidid>0000-0002-3797-8008</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00270-020-02640-0$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00270-020-02640-0$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>230,314,776,780,881,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33025244$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Periyasamy, Sarvesh</creatorcontrib><creatorcontrib>Hoffman, Carson A.</creatorcontrib><creatorcontrib>Longhurst, Colin</creatorcontrib><creatorcontrib>Schefelker, Georgia C.</creatorcontrib><creatorcontrib>Ozkan, Orhan S.</creatorcontrib><creatorcontrib>Speidel, Michael A.</creatorcontrib><creatorcontrib>Laeseke, Paul F.</creatorcontrib><title>A Quantitative Digital Subtraction Angiography Technique for Characterizing Reduction in Hepatic Arterial Blood Flow During Transarterial Embolization</title><title>Cardiovascular and interventional radiology</title><addtitle>Cardiovasc Intervent Radiol</addtitle><addtitle>Cardiovasc Intervent Radiol</addtitle><description>Objective
There is no standardized and objective method for determining the optimal treatment endpoint (sub-stasis) during transarterial embolization. The objective of this study was to demonstrate the feasibility of using a quantitative digital subtraction angiography (qDSA) technique to characterize intra-procedural changes in hepatic arterial blood flow velocity in response to transarterial embolization in an in vivo porcine model.
Materials and Methods
Eight domestic swine underwent bland transarterial embolizations to partial- and sub-stasis angiographic endpoints with intraprocedural DSA acquisitions. Embolized lobes were assessed on histopathology for ischemic damage and tissue embolic particle density. Analysis of target vessels used qDSA and a commercially available color-coded DSA (ccDSA) tool to calculate blood flow velocities and time-to-peak, respectively.
Results
Blood flow velocities calculated using qDSA showed a statistically significant difference (
p
< 0.01) between partial- and sub-stasis endpoints, whereas time-to-peak calculated using ccDSA did not show a significant difference. During the course of embolizations, the average correlation with volume of particles delivered was larger for qDSA (− 0.86) than ccDSA (0.36). There was a statistically smaller mean squared error (
p
< 0.01) and larger coefficient of determination (
p
< 0.01) for qDSA compared to ccDSA. On pathology, the degree of embolization as calculated by qDSA had a moderate, positive correlation (
p
< 0.01) with the tissue embolic particle density of ischemic regions within the embolized lobe.
Conclusions
qDSA was able to quantitatively discriminate angiographic embolization endpoints and, compared to a commercially available ccDSA method, improve intra-procedural characterization of blood flow changes. Additionally, the qDSA endpoints correlated with tissue-level changes.</description><subject>Angiography</subject><subject>Angiography, Digital Subtraction - methods</subject><subject>Animals</subject><subject>Blood flow</subject><subject>Blood Flow Velocity - physiology</subject><subject>Cardiology</subject><subject>Chemoembolization</subject><subject>Correlation</subject><subject>Embolisation (arterial)</subject><subject>Embolization</subject><subject>Embolization, Therapeutic - methods</subject><subject>Evaluation Studies as Topic</subject><subject>Feasibility Studies</subject><subject>Flow velocity</subject><subject>Hepatic Artery - diagnostic imaging</subject><subject>Hepatic Artery - physiopathology</subject><subject>Histopathology</subject><subject>Imaging</subject><subject>In vivo methods and tests</subject><subject>Ischemia</subject><subject>Laboratory Investigation</subject><subject>Liver</subject><subject>Liver cancer</subject><subject>Livestock</subject><subject>Medical imaging</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Nuclear Medicine</subject><subject>Particle density (concentration)</subject><subject>Radiology</subject><subject>Statistical analysis</subject><subject>Swine</subject><subject>Tissue analysis</subject><subject>Tissues</subject><subject>Ultrasound</subject><issn>0174-1551</issn><issn>1432-086X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNp9kc1u1DAUhS0EokPhBVggS2zYBOzYjpMN0jBtKVIlBAwSO8txbjKuMnZqJ0Xtg_R565C2_CxY-Ee63z32PQehl5S8pYTId5GQXJKM5PMqeNofoRXlLM9IWfx4jFaESp5RIegBehbjOSFUlLl4ig4YI7nIOV-hmzX-Mmk32lGP9hLwke3StcffpnoM2ozWO7x2nfVd0MPuCm_B7Jy9mAC3PuDNTs8QBHttXYe_QjMtLdbhUxiSpMHrMNeT5Ife-waf9P4nPprCzG-DdlHf14_3te_ttZ4FnqMnre4jvLg7D9H3k-Pt5jQ7-_zx02Z9lhku-ZgxCsyAYKTUphU1rwBMKxshCmlqUdZc87LQRCSbatJK2gCrWwFtwxnUpGDsEL1fdIep3kNjwKWpezUEu9fhSnlt1d8VZ3eq85dKlkJwXiaBN3cCwSdX4qj2Nhroe-3AT1Elkysqq6qiCX39D3rup-DSeImSkpU5FyJR-UKZ4GMM0D58hhI1x66W2FWKXf2KXZHU9OrPMR5a7nNOAFuAOMzOQ_j99n9kbwGFwryy</recordid><startdate>20210201</startdate><enddate>20210201</enddate><creator>Periyasamy, Sarvesh</creator><creator>Hoffman, Carson A.</creator><creator>Longhurst, Colin</creator><creator>Schefelker, Georgia C.</creator><creator>Ozkan, Orhan S.</creator><creator>Speidel, Michael A.</creator><creator>Laeseke, Paul F.</creator><general>Springer US</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7TO</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>H94</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-3797-8008</orcidid></search><sort><creationdate>20210201</creationdate><title>A Quantitative Digital Subtraction Angiography Technique for Characterizing Reduction in Hepatic Arterial Blood Flow During Transarterial Embolization</title><author>Periyasamy, Sarvesh ; Hoffman, Carson A. ; Longhurst, Colin ; Schefelker, Georgia C. ; Ozkan, Orhan S. ; Speidel, Michael A. ; Laeseke, Paul F.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c474t-31e3ce5308acf5b49eecf7d5567cb58b4a486a05270b0f71de3bf5efd43eb0633</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Angiography</topic><topic>Angiography, Digital Subtraction - methods</topic><topic>Animals</topic><topic>Blood flow</topic><topic>Blood Flow Velocity - physiology</topic><topic>Cardiology</topic><topic>Chemoembolization</topic><topic>Correlation</topic><topic>Embolisation (arterial)</topic><topic>Embolization</topic><topic>Embolization, Therapeutic - methods</topic><topic>Evaluation Studies as Topic</topic><topic>Feasibility Studies</topic><topic>Flow velocity</topic><topic>Hepatic Artery - diagnostic imaging</topic><topic>Hepatic Artery - physiopathology</topic><topic>Histopathology</topic><topic>Imaging</topic><topic>In vivo methods and tests</topic><topic>Ischemia</topic><topic>Laboratory Investigation</topic><topic>Liver</topic><topic>Liver cancer</topic><topic>Livestock</topic><topic>Medical imaging</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Nuclear Medicine</topic><topic>Particle density (concentration)</topic><topic>Radiology</topic><topic>Statistical analysis</topic><topic>Swine</topic><topic>Tissue analysis</topic><topic>Tissues</topic><topic>Ultrasound</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Periyasamy, Sarvesh</creatorcontrib><creatorcontrib>Hoffman, Carson A.</creatorcontrib><creatorcontrib>Longhurst, Colin</creatorcontrib><creatorcontrib>Schefelker, Georgia C.</creatorcontrib><creatorcontrib>Ozkan, Orhan S.</creatorcontrib><creatorcontrib>Speidel, Michael A.</creatorcontrib><creatorcontrib>Laeseke, Paul F.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Oncogenes and Growth Factors Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Cardiovascular and interventional radiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Periyasamy, Sarvesh</au><au>Hoffman, Carson A.</au><au>Longhurst, Colin</au><au>Schefelker, Georgia C.</au><au>Ozkan, Orhan S.</au><au>Speidel, Michael A.</au><au>Laeseke, Paul F.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>A Quantitative Digital Subtraction Angiography Technique for Characterizing Reduction in Hepatic Arterial Blood Flow During Transarterial Embolization</atitle><jtitle>Cardiovascular and interventional radiology</jtitle><stitle>Cardiovasc Intervent Radiol</stitle><addtitle>Cardiovasc Intervent Radiol</addtitle><date>2021-02-01</date><risdate>2021</risdate><volume>44</volume><issue>2</issue><spage>310</spage><epage>317</epage><pages>310-317</pages><issn>0174-1551</issn><eissn>1432-086X</eissn><abstract>Objective
There is no standardized and objective method for determining the optimal treatment endpoint (sub-stasis) during transarterial embolization. The objective of this study was to demonstrate the feasibility of using a quantitative digital subtraction angiography (qDSA) technique to characterize intra-procedural changes in hepatic arterial blood flow velocity in response to transarterial embolization in an in vivo porcine model.
Materials and Methods
Eight domestic swine underwent bland transarterial embolizations to partial- and sub-stasis angiographic endpoints with intraprocedural DSA acquisitions. Embolized lobes were assessed on histopathology for ischemic damage and tissue embolic particle density. Analysis of target vessels used qDSA and a commercially available color-coded DSA (ccDSA) tool to calculate blood flow velocities and time-to-peak, respectively.
Results
Blood flow velocities calculated using qDSA showed a statistically significant difference (
p
< 0.01) between partial- and sub-stasis endpoints, whereas time-to-peak calculated using ccDSA did not show a significant difference. During the course of embolizations, the average correlation with volume of particles delivered was larger for qDSA (− 0.86) than ccDSA (0.36). There was a statistically smaller mean squared error (
p
< 0.01) and larger coefficient of determination (
p
< 0.01) for qDSA compared to ccDSA. On pathology, the degree of embolization as calculated by qDSA had a moderate, positive correlation (
p
< 0.01) with the tissue embolic particle density of ischemic regions within the embolized lobe.
Conclusions
qDSA was able to quantitatively discriminate angiographic embolization endpoints and, compared to a commercially available ccDSA method, improve intra-procedural characterization of blood flow changes. Additionally, the qDSA endpoints correlated with tissue-level changes.</abstract><cop>New York</cop><pub>Springer US</pub><pmid>33025244</pmid><doi>10.1007/s00270-020-02640-0</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0002-3797-8008</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Angiography Angiography, Digital Subtraction - methods Animals Blood flow Blood Flow Velocity - physiology Cardiology Chemoembolization Correlation Embolisation (arterial) Embolization Embolization, Therapeutic - methods Evaluation Studies as Topic Feasibility Studies Flow velocity Hepatic Artery - diagnostic imaging Hepatic Artery - physiopathology Histopathology Imaging In vivo methods and tests Ischemia Laboratory Investigation Liver Liver cancer Livestock Medical imaging Medicine Medicine & Public Health Nuclear Medicine Particle density (concentration) Radiology Statistical analysis Swine Tissue analysis Tissues Ultrasound |
| title | A Quantitative Digital Subtraction Angiography Technique for Characterizing Reduction in Hepatic Arterial Blood Flow During Transarterial Embolization |
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