Quantitative Portal Vein Velocity of Liver Cancer Patients with Transcatheter Arterial Chemoembolization on Angiography

Objective. We applied optical flow method (OFM) to quantify relative velocities of blood flow using digital subtraction angiography (DSA) in the vascular analysis of hepatocellular carcinoma (HCC) patients who underwent transarterial chemoembolization (TACE) treatment. Methods. A total of 40 HCC patients treated by TACE were analyzed in this study. DSA imaging with a 12-inch field of view, 1024 × 1024 pixels and 4 frames/second was acquired. OFM developed for motion estimation is applied for blood flow estimation. Two acrylic phantoms were built to validate the method. Results. The relationship between the OFM and Doppler measurements was found linear with R 2 = 0.99 for both straight and curved tube phantoms. Quantitative blood flow distribution images of the portal vein region were presented. After TACE, the minimum, maximum and mean velocities in the portal vein all decreased (P < 0.05). Additionally, the velocity in the portal vein is significantly lower with a higher Child-Pugh score (P < 0.01). Conclusions. The present technique provides add-on quantitative information of flows to DSA and the hemodynamic analysis in relative quantifications of blood flow in portal vein of hepatocellular carcinoma patients using DSA.

[1]  H. Toyoda,et al.  Impact of a unified CT angiography system on outcome of patients with hepatocellular carcinoma. , 2009, AJR. American journal of roentgenology.

[2]  L. Bolondi,et al.  Value of measurement of mean portal flow velocity by Doppler flowmetry in the diagnosis of portal hypertension. , 1992, Journal of hepatology.

[3]  J. Marrero,et al.  Prognosis of hepatocellular carcinoma: Comparison of 7 staging systems in an American cohort , 2005, Hepatology.

[4]  E. Keeler,et al.  Primer on certain elements of medical decision making. , 1975, The New England journal of medicine.

[5]  L. Qin,et al.  Study of severe and rare complications of transarterial chemoembolization (TACE) for liver cancer. , 2006, European journal of radiology.

[6]  Geoffrey G. Zhang,et al.  Accuracy evaluation of RBC velocity measurement in nail-fold capillaries. , 2011, Microvascular research.

[7]  Katsuyoshi Ito,et al.  Iodized oil accumulation in hypervascular hepatocellular carcinoma after transcatheter arterial chemoembolization: comparison of imaging findings with CT during hepatic arteriography. , 2008, Journal of vascular and interventional radiology : JVIR.

[8]  S. Ishiguro,et al.  A new approach to chemoembolization therapy for hepatoma using ethiodized oil, cisplatin, and gelatin sponge , 1987, Cancer.

[9]  Geoffrey Zhang,et al.  Red blood cell velocity measurements of complete capillary in finger nail-fold using optical flow estimation. , 2009, Microvascular research.

[10]  R. Close,et al.  X-ray videodensitometric methods for blood flow and velocity measurement: a critical review of literature. , 2000, Medical physics.

[11]  Kawal S. Rhode,et al.  Novel approaches to the measurement of arterial blood flow from dynamic digital X-ray images , 2005, IEEE Transactions on Medical Imaging.

[12]  G. Otto,et al.  MDCT Versus MRI Assessment of Tumor Response After Transarterial Chemoembolization for the Treatment of Hepatocellular Carcinoma , 2010, CardioVascular and Interventional Radiology.

[13]  Berthold K. P. Horn,et al.  Determining Optical Flow , 1981, Other Conferences.

[14]  Tzu-Ching Shih,et al.  Hemodynamic analysis of capillary in finger nail-fold using computational fluid dynamics and image estimation. , 2011, Microvascular research.

[15]  J. Meunier,et al.  Optical flow assessment of parabolic velocity profile in cineangiography: a simulation study , 1995, Proceedings of 17th International Conference of the Engineering in Medicine and Biology Society.

[17]  K. Stuart.  Chemoembolization in the management of liver tumors. , 2003, The oncologist.

[18]  J. Geschwind,et al.  Transcatheter Arterial Chemoembolization for Liver Cancer: Is It Time to Distinguish Conventional from Drug-Eluting Chemoembolization? , 2011, CardioVascular and Interventional Radiology.

[19]  Max A. Viergever,et al.  Mutual-information-based registration of medical images: a survey , 2003, IEEE Transactions on Medical Imaging.

[20]  T. de Baère,et al.  Trans-catheter arterial chemoembolization as first-line treatment for hepatic metastases from endocrine tumors , 2002, European Radiology.

[21]  Y. Shin,et al.  Influence of preoperative portal hypertension and graft size on portal blood flow velocity in recipient after living donor liver transplantation with right-lobe graft. , 2010, AJR. American journal of roentgenology.

[22]  Paul A. Viola,et al.  Multi-modal volume registration by maximization of mutual information , 1996, Medical Image Anal..

[23]  Guy Marchal,et al.  Multimodality image registration by maximization of mutual information , 1997, IEEE Transactions on Medical Imaging.

[24]  Wen-Chen Lin,et al.  Red Blood Cell Velocity Measurement in Rodent Tumor Model: An in vivo Microscopic Study , 2012 .

[25]  T. Konno.  Targeting cancer chemotherapeutic agents by use of lipiodol contrast medium , 1990, Cancer.

[26]  Wen-Chen Lin,et al.  Experimental estimation of blood flow velocity through simulation of intravital microscopic imaging in micro-vessels by different image processing methods. , 2010, Microvascular research.