ABSTRACT
PURPOSE: Cross-institutional establishment of standardized protocols for CT and MR imaging of primary liver and pancreas tumors in an oncological center. MATERIALS AND METHODS: This prospective dual-institution study was approved by the local IRBs. Minimum requirements (phases, sequences, slice thickness) for imaging of primary liver and pancreas tumors were defined and implemented at both sites. Between 06/19 and 08/19 in-house examinations were evaluated in terms of compliance with defined protocols and image quality. In addition, extramural examinations that were demonstrated at interdisciplinary tumor board meetings in the same study period were reviewed. Results were analyzed by means of descriptive statistics, and differences between centers, modalities and organs assessed (Fisher-exact Test, pâ<â0.05 deemed significant). RESULTS: 480 data sets (397 internal, 83 extramural) were included in this study and analyzed. Overall protocol compliance for in-house examinations was 93.5â% (371/397 datasets), without statistical significant difference between the two institutions (pâ=â0.0615). External studies met minimum requirements in 48.2â% (40/83 datasets). Regarding in-house imaging, significant differences were observed between CT of the liver and the pancreas (pâ<â0.05) and between CT and MRI of the pancreas (pâ<â0.05). CONCLUSION: As demonstrated in this pilot project, cross-institutional establishment of standardized imaging protocols is feasible with a compliance rate of more than 90â%. Standardized imaging protocols may serve as a quality indicator in oncological imaging, and over time, improve cross-institutional patient care. KEY POINTS: · Cross-institutional establishment of standardized imaging protocols is feasible with high compliance.. · Standards may serve as a quality indicator in oncological imaging.. · In perspective, cross-institutional patient care may be improved.. CITATION FORMAT: · Römermann I, Al-Bourini O, Seif Amir Hosseini A etâal. Cross-insitutional standardization of imaging protocols - A pilot study within the scope of the Comprehensive Cancer Center Lower Saxony. Fortschr Röntgenstr 2021; 193: 410â-â416.
Subject(s)
Liver Neoplasms , Magnetic Resonance Imaging , Pancreatic Neoplasms , Tomography, X-Ray Computed , Clinical Protocols/standards , Humans , Liver Neoplasms/diagnostic imaging , Magnetic Resonance Imaging/methods , Pancreatic Neoplasms/diagnostic imaging , Pilot Projects , Prospective Studies , Tomography, X-Ray Computed/methodsABSTRACT
Purpose: To compare the efficacy of right portal vein embolization using ethylene vinyl alcohol (EVOH-PVE) compared to other embolic agents and surgical right portal vein ligation (PVL).Material and methods: Patients with right sided liver malignancies scheduled for extensive surgery and receiving induction of liver hypertrophy via right portal vein embolization/ligature between 2010-2016 were retrospectively evaluated. Treatments included were ethylene vinyl alcohol copolymer (Onyx®, EVOH-PVE), ethiodized oil (Lipiodol®, Lipiodol/PVA-PVE), polyvinyl alcohol (PVA-PVE) or surgical ligature (PVL). Liver segments S2/3 were used to assess hypertrophy. Primary outcome was future liver remnant growth in ml/day.Results: Forty-one patients were included (EVOH-PVE n = 11; Lipiodol/PVA-PVE n = 10; PVA-PVE n = 8; PVL n = 12), the majority presenting with cholangiocarcinoma and colorectal metastases (n = 11; n = 27). Pre-interventional liver volumes were comparable (p = .095). Liver hypertrophy was successfully induced in all but one patient receiving Lipiodol/PVA-PVE. Liver segment S2/3 growth was largest for EVOH-PVE (5.38 ml/d) followed by PVA-PVE (2.5 ml/d), with significantly higher growth rates than PVL (1.24 ml/d; p < .001; p = .007). No significant difference was evident for Lipiodol/PVA-PVE (1.43 ml/d, p = .809).Conclusions: Portal vein embolization using EVOH demonstrates fastest S2/3 growth rates compared to other embolic agents and PVL, potentially due to its permanent portal vein embolization and induction of hepatic inflammation.