Estimation of intra-arterial chemotherapy distribution to the retina in pediatric retinoblastoma patients using quantitative digital subtraction angiography
| Autor: | Katherine K. Matthay, Matthew R Amans, Bertil Damato, Robert Darflinger, Randall T. Higashida, Steven W. Hetts, Andrew Kao, Daniel L Cooke, Sravani Kondapavulur, Christopher F. Dowd, Van V. Halbach, Matthew D Alexander |
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| Rok vydání: | 2018 |
| Předmět: |
Male
Retinal Neoplasms Interclass correlation Ophthalmic Artery 03 medical and health sciences 0302 clinical medicine medicine.artery medicine Humans Infusions Intra-Arterial Antineoplastic Agents Alkylating Melphalan Retrospective Studies medicine.diagnostic_test Retinoblastoma business.industry Angiography Digital Subtraction Infant Digital subtraction angiography medicine.disease Confidence interval medicine.anatomical_structure Child Preschool Ophthalmic artery 030221 ophthalmology & optometry Female Choroid Internal carotid artery Nuclear medicine business Carotid Artery Internal 030217 neurology & neurosurgery Head and Neck Artery |
| Zdroj: | Interventional Neuroradiology. 24:214-219 |
| ISSN: | 2385-2011 1591-0199 |
| DOI: | 10.1177/1591019917749825 |
| Popis: | Background and purpose The purpose of this article is to estimate the distribution of superselective intra-arterial chemotherapy (IAC) delivery to ocular target tissue using quantitative digital subtraction angiography (qDSA). Materials and methods From March 2010 to January 2016, 50 ophthalmic artery contrast DSAs obtained immediately prior to IAC infusions in 22 patients were analyzed. This study was conducted under a retrospective review IRB (no. 10-01862). Parametric color-coded DSAs (iFlow, Siemens Medical) were post-processed (MATLAB, The Mathworks Inc.) using two methods: two box regions of interest (pre-retina and globe) and four custom regions of interest (ROIs—ophthalmic artery, choroid, supraclinoid internal carotid artery (ICA), cavernous ICA). Mean interobserver reliability of custom ROI selection is presented as a 95% confidence interval of interclass correlation, and fractional chemotherapy delivery to selected ROIs as means ± standard deviation in this study. Results The estimated fraction of chemotherapy delivered to the globe with the first method was 79.5%. Percentage regional delivery using the second method was as follows: ophthalmic artery, 85.8%; choroid, 60.5%; supraclinoid ICA, 14.2%. The cavernous ICA ROI (encompassing distal catheter and potential reflux) gave a signal equivalent to 9.3% of total delivery. Conclusion Parametric color-coded qDSA can estimate the fraction of IAC delivered to the retina and other orbital structures in ocular retinoblastoma patients. This information can inform delivery location and dosing strategies on a patient-specific basis. |
| Databáze: | OpenAIRE |
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