Application of DynaCT angiographic reconstruction in balloon pulmonary angioplasty
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INTERVENTIONAL
Application of DynaCT angiographic reconstruction in balloon pulmonary angioplasty Jie-Long Lin 1 & Hai-Ming Chen 2 & Feng-Cheng Lin 2 & Jie-Ying Li 2 & Cheng-Xin Xie 3 & Wen-Liang Guo 2 & Xiu-Fen Huang 4 & Cheng Hong 2 Received: 8 November 2019 / Revised: 2 May 2020 / Accepted: 10 June 2020 # European Society of Radiology 2020
Abstract Objectives To investigate the feasibility and accuracy of balloon pulmonary angioplasty (BPA) using DynaCT angiographic reconstruction guidance. Methods Thirty-four BPAs (23 CTEPH patients) targeting 175 pulmonary arteries were included. Eleven BPAs (2D group) were guided by DSA two-dimensional angiography. Another twenty-three BPAs (3D group) were guided using DynaCT angiographic reconstruction. The volume rendering (VR) method was used to obtain a three-dimensional image of the blood vessels. This image was used as a reference to continue BPA treatment under the guidance of vascular three-dimensional reconstruction technology. Procedure durations and radiation exposure data were compared between the two groups using Mann–Whitney U test. Results Using the DynaCT angiographic reconstruction technique, more target vessels were treated in a single BPA procedure (5.83 ± 2.33 vs 3.73 ± 1.10 vessels per BPA, p = 0.008) in a shorter operation time (3.58 ± 0.61 vs 4.49 ± 0.91 h, p = 0.002). Overall, the dose area product (DAP) was significantly higher for the 2D group than for the 3D group (13,901.82 ± 5549.69 vs 4682.82 ± 1950.64, p < 0.001). The use of the DynaCT angiographic reconstruction technique to guide BPA required a lower dose of contrast agent (225.22 ± 48.70 vs 292.73 ± 76.82 mL, p = 0.013) and less radiation exposure. Conclusions The use of DynaCT angiographic reconstruction guidance in patients undergoing BPA is feasible and accurate. Images of DynaCT angiographic reconstruction may be beneficial for optimizing the operative process in BPA with reduced radiation exposure. Key Points • BPA guidance by DynaCT angiographic reconstruction is feasible and accurate. • DynaCT angiographic reconstruction may be beneficial for optimizing the operative process. • DynaCT angiographic reconstruction can reduce patient radiation dose due to multi-times of BPA sessions. Keywords Angioplasty . Pulmonary hypertension . Cone beam computed tomography
Jie-Long Lin and Hai-Ming Chen contributed equally to this work. * Cheng Hong [email protected] 1
Department of Radiology, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510010, China
2
State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, 151 Yanjiang Road, Guangzhou 510010, China
3
Department of Pulmonary and Critical Care Medicine, The First People’s Hospital of Kashgar Prefecture, Kashgar, Xinjiang 844000, China
4
The First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510010, China
Abbreviations 2D Two-dimensional 3D Three-
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