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Neuroimaging
Original research
Flat-detector computed tomography PBV map in the evaluation of presurgical embolization for hypervascular brain tumors
  1. Li-Li Wen1,
  2. Xin Zhang2,
  3. Qing-Rong Zhang2,
  4. Qi Wu2,
  5. Shu-Juan Chen2,
  6. Jin-Long Deng2,
  7. Kaiyi Huang3,
  8. Han-Dong Wang1
  1. 1 Department of Neurosurgery, Jinling Hospital, Jinling School of Clinical Medicine, Nanjing Medical University, Nanjing, PR China
  2. 2 Department of Neurosurgery, Jinling Hospital, Nanjing University School of Medicine, Nanjing, PR China
  3. 3 Siemens Healthcare China, Shanghai, China
  1. Correspondence to Dr Xin Zhang, Department of Neurosurgery, Jinling Hospital, Nanjing University School of Medicine, No. 305 East Zhongshan Road, Nanjing 210002, PR China; zhangxsp{at}163.com Dr Han-dong Wang, Department of Neurosurgery, Jinling Hospital, Jinling School of Clinical Medicine, Nanjing Medical University. No. 305 East Zhongshan Road, Nanjing, 210002, PR China; njhdwang@hotmail.com

Abstract

Background Preoperative embolization of hypervascular brain tumors is frequently used to minimize intraoperative bleeding.

Objective To explore the efficacy of embolization using flat-detector CT (FDCT) parenchymal blood volume (PBV) maps before and after the intervention.

Materials and methods Twenty-five patients with hypervascular brain tumors prospectively received pre- and postprocedural FDCT PBV scans using a biplane system under a protocol approved by the institutional research ethics committee. Semiquantitative analysis, based on region of interest measurements of the pre- and post-embolization PBV maps, operating time, and blood loss, was performed to assess the feasibility of PBV maps in detecting the perfusion deficit and to evaluate the efficacy of embolization.

Results Preoperative embolization was successful in 18 patients. The relative PBV decreased significantly from 3.98±1.41 before embolization to 2.10±2.00 after embolization. Seventeen patients underwent surgical removal of tumors 24 hours after embolization. The post-embolic tumor perfusion index correlated significantly with blood loss (ρ=0.55) and operating time (ρ=0.60).

Conclusions FDCT PBV mapping is a useful method for evaluating the perfusion of hypervascular brain tumors and the efficacy of embolization. It can be used as a supplement to CT perfusion, MRI, and DSA in the evaluation of tumor embolization.

  • CT perfusion
  • Tumor
  • Embolic

https://doi.org/10.1136/neurintsurg-2016-012658

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    Footnotes

    • Contributors H-DW and XZ contributed equally to the article. Study concepts: L-LW, XZ, H-DW. Study design: L-LW, XZ, H-DW. Data acquisition: Q-RZ, QW, S-JC, J-LD. Quality control of data and algorithms: J-LD, L-LW. Data analysis and interpretation: Q-RZ, QW. Statistical analysis: KH, S-JC. Manuscript preparation: L-LW, XZ, H-DW. Manuscript editing: KH. Manuscript review: XZ, H-DW.

    • Funding This work was supported by the National Natural Science Foundation of China (grant number 81471183) and by a grant from Jinling Hospital (grant number 2016006).

    • Competing interests None declared.

    • Patient consent Obtained.

    • Ethics approval This study was approved by the ethical committee of the Jinling Hospital, and the patients provided written informed consent before beginning treatment.

    • Provenance and peer review Not commissioned; externally peer reviewed.