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• W3000484865 abstract "Introduction: Arterial-phase contrast significantly improves the definition of primary HCC liver lesions [1]. Determining an appropriate method of delivering optimal arterial-phase enhancement is challenging when used in conjunction with breath-hold scanning techniques in a cohort of patients who often have compromised venous access and reduced cardiac output. This project investigates a method of giving arterial phase contrast to primary HCC lesions in conjunction with breath hold techniques, accounting for reduced flow rates and reduced cardiac outputs. This will be done with a method of personalised contrast delays derived from repeated single CT slices. Method: Diagnostic scanning protocols were deemed unsuitable for integration with radiotherapy scanning practices due to differences in scan procedures. Initially adjustments were made to the time delay between contrast injection and CT scan based on injection speed and scan duration which resulted in some increase in arterial-phase enhancement. However, a large volume of contrast often remained in the heart due to variation in injection speed and differing cardiac functions. To improve on this, a test-bolus of contrast was injected to ascertain a patient-specific delay derived from the time from contrast injection to detection of contrast by Hounsfield density in the target vessels. [HC1] Results: Calculating a patient-specific time delay gives a robust method of delivering arterial-phase contrast. This negates the requirement for triggered CT scanning[HC2] , allowing arterial-phase contrast to be used in conjunction with voluntary breath-hold techniques. Target volume definition for primary HCC liver lesions has subsequently been improved. Conclusion: Fixed time delays do not always give optimal arterial-phase contrast enhancement to images. Calculating a patient-specific time delay allows delivery of arterial-phase contrast in conjunction with voluntary breath-hold techniques. Having a robust method of producing a precise time reduces the risk of additional scans being required while improving the quality of arterial-phase enhancement. [HC1]Need more detail on what was measureed and how [HC2]What's the problem with triggered CT scanning? Numerical References 1. Xu, H., Gong, G., Wei, H., Chen, L., Chen, J., Lu, J., Liu, T., Zhu, J. and Yin, Y. (2014). Feasibility and potential benefits of defining the internal gross tumor volume of hepatocellular carcinoma using contrast-enhanced 4D CT images obtained by deformable registration. Radiation Oncology, 9(1)." @default.
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• W3000484865 date "2020-01-01" @default.
• W3000484865 modified "2023-09-24" @default.
• W3000484865 title "Implementing patient specific arterial phase contrast time delays in radiotherapy planning scans for HCC SABR patients" @default.
• W3000484865 doi "https://doi.org/10.1016/j.radi.2019.11.064" @default.
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