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Title: Three-dimensional Image Fusion Guidance for Transjugular Intrahepatic Portosystemic Shunt Placement

Abstract

IntroductionTo assess the safety, feasibility and effectiveness of image fusion guidance with pre-procedural portal phase computed tomography with intraprocedural fluoroscopy for transjugular intrahepatic portosystemic shunt (TIPS) placement.Materials and methodsAll consecutive cirrhotic patients presenting at our interventional unit for TIPS creation from January 2015 to January 2016 were prospectively enrolled. Procedures were performed under general anesthesia in an interventional suite equipped with flat panel detector, cone-beam computed tomography (CBCT) and image fusion technique. All TIPSs were placed under image fusion guidance. After hepatic vein catheterization, an unenhanced CBCT acquisition was performed and co-registered with the pre-procedural portal phase CT images. A virtual path between hepatic vein and portal branch was made using the virtual needle path trajectory software. Subsequently, the 3D virtual path was overlaid on 2D fluoroscopy for guidance during portal branch cannulation. Safety, feasibility, effectiveness and per-procedural data were evaluated.ResultsSixteen patients (12 males; median age 56 years) were included. Procedures were technically feasible in 15 of the 16 patients (94%). One procedure was aborted due to hepatic vein catheterization failure related to severe liver distortion. No periprocedural complications occurred within 48 h of the procedure. The median dose-area product was 91 Gy cm{sup 2}, fluoroscopy time 15 min, procedure time 40 min and contrast mediamore » consumption 65 mL. Clinical benefit of the TIPS placement was observed in nine patients (56%).ConclusionThis study suggests that 3D image fusion guidance for TIPS is feasible, safe and effective. By identifying virtual needle path, CBCT enables real-time multiplanar guidance and may facilitate TIPS placement.« less

Authors:
; ; ; ; ; ; ;  [1];  [2];  [3]; ;  [1]
  1. CHU Henri Mondor, Assistance Publique – Hôpitaux de Paris (AP-HP), Service d’Imagerie Médicale (France)
  2. Université Paris-Est Créteil (UPEC) (France)
  3. CHU Henri Mondor, Assistance Publique – Hôpitaux de Paris (AP-HP), Service de Chirurgie Digestive (France)
Publication Date:
OSTI Identifier:
22756336
Resource Type:
Journal Article
Journal Name:
Cardiovascular and Interventional Radiology
Additional Journal Information:
Journal Volume: 40; Journal Issue: 11; Other Information: Copyright (c) 2017 Springer Science+Business Media, LLC and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE); Article Copyright (c) 2017 Springer Science+Business Media New York and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE); http://www.springer-ny.com; Country of input: International Atomic Energy Agency (IAEA); Journal ID: ISSN 0174-1551
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; BYPASSES; COMPUTER CODES; COMPUTERIZED TOMOGRAPHY; CONTRAST MEDIA; FLUOROSCOPY; GY RANGE; IMAGE PROCESSING; LIVER; PATIENTS; RADIATION DOSES; THREE-DIMENSIONAL CALCULATIONS; VEINS

Citation Formats

Tacher, Vania, Petit, Arthur, Derbel, Haytham, Novelli, Luigi, Vitellius, Manuel, Ridouani, Fourat, Luciani, Alain, Rahmouni, Alain, Duvoux, Christophe, Salloum, Chady, Chiaradia, Mélanie, and Kobeiter, Hicham. Three-dimensional Image Fusion Guidance for Transjugular Intrahepatic Portosystemic Shunt Placement. United States: N. p., 2017. Web. doi:10.1007/S00270-017-1699-9.
Tacher, Vania, Petit, Arthur, Derbel, Haytham, Novelli, Luigi, Vitellius, Manuel, Ridouani, Fourat, Luciani, Alain, Rahmouni, Alain, Duvoux, Christophe, Salloum, Chady, Chiaradia, Mélanie, & Kobeiter, Hicham. Three-dimensional Image Fusion Guidance for Transjugular Intrahepatic Portosystemic Shunt Placement. United States. doi:10.1007/S00270-017-1699-9.
Tacher, Vania, Petit, Arthur, Derbel, Haytham, Novelli, Luigi, Vitellius, Manuel, Ridouani, Fourat, Luciani, Alain, Rahmouni, Alain, Duvoux, Christophe, Salloum, Chady, Chiaradia, Mélanie, and Kobeiter, Hicham. Wed . "Three-dimensional Image Fusion Guidance for Transjugular Intrahepatic Portosystemic Shunt Placement". United States. doi:10.1007/S00270-017-1699-9.
@article{osti_22756336,
title = {Three-dimensional Image Fusion Guidance for Transjugular Intrahepatic Portosystemic Shunt Placement},
author = {Tacher, Vania and Petit, Arthur and Derbel, Haytham and Novelli, Luigi and Vitellius, Manuel and Ridouani, Fourat and Luciani, Alain and Rahmouni, Alain and Duvoux, Christophe and Salloum, Chady and Chiaradia, Mélanie and Kobeiter, Hicham},
abstractNote = {IntroductionTo assess the safety, feasibility and effectiveness of image fusion guidance with pre-procedural portal phase computed tomography with intraprocedural fluoroscopy for transjugular intrahepatic portosystemic shunt (TIPS) placement.Materials and methodsAll consecutive cirrhotic patients presenting at our interventional unit for TIPS creation from January 2015 to January 2016 were prospectively enrolled. Procedures were performed under general anesthesia in an interventional suite equipped with flat panel detector, cone-beam computed tomography (CBCT) and image fusion technique. All TIPSs were placed under image fusion guidance. After hepatic vein catheterization, an unenhanced CBCT acquisition was performed and co-registered with the pre-procedural portal phase CT images. A virtual path between hepatic vein and portal branch was made using the virtual needle path trajectory software. Subsequently, the 3D virtual path was overlaid on 2D fluoroscopy for guidance during portal branch cannulation. Safety, feasibility, effectiveness and per-procedural data were evaluated.ResultsSixteen patients (12 males; median age 56 years) were included. Procedures were technically feasible in 15 of the 16 patients (94%). One procedure was aborted due to hepatic vein catheterization failure related to severe liver distortion. No periprocedural complications occurred within 48 h of the procedure. The median dose-area product was 91 Gy cm{sup 2}, fluoroscopy time 15 min, procedure time 40 min and contrast media consumption 65 mL. Clinical benefit of the TIPS placement was observed in nine patients (56%).ConclusionThis study suggests that 3D image fusion guidance for TIPS is feasible, safe and effective. By identifying virtual needle path, CBCT enables real-time multiplanar guidance and may facilitate TIPS placement.},
doi = {10.1007/S00270-017-1699-9},
journal = {Cardiovascular and Interventional Radiology},
issn = {0174-1551},
number = 11,
volume = 40,
place = {United States},
year = {2017},
month = {11}
}