Abstract No. 488 - Accuracy of Virtual Parenchymal Perfusion software in predicting treatment volumes during intra-arterial therapies

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Virtual Parenchymal Perfusion (Philips) is investigational software that displays the liver tissue area and volume perfused by a specific vessel. Therefore the operator is able to predict the treatment volume based on planned catheter position using planning arterial phase cone-beam computed tomography (CBCT) during intra-arterial therapy. Potential advantages include the ability to determine therapeutic dosing, optimal catheter position for drug delivery and reducing non-target embolization. The purpose is to assess the accuracy of Virtual Parenchymal Perfusion software in predicting the volume of liver that will be treated from a specific catheter position based on arterial CBCT. Dual phase (arterial and venous) CBCT is obtained for planning at the beginning of all intra-arterial liver therapies. Selective arterial CBCT with catheter in target vessel is routinely performed prior to therapy. The volume of the liver opacified during the selective arterial CBCT was segmented using embolization planning software (Emboguide Philips) and recorded in mLs. Using Virtual Parenchymal Perfusion software on the planning non-selective arterial CBCT, a virtual catheter was positioned in the same location as the actual catheter position on the selective CBCT. The software displayed the predicted liver volume that will be treated from that catheter position and provided the volume in mL. The latter was recorded and compared to the segmented volume on selective CBCT. The selective CBCT volume was considered the ground truth. In all of the cases, the predicted volume was visually in accordance with the actual injection. More importantly, the average predicted liver volume was 490.7 ± 243.1 mL. The average actual volume was 518 ± 245.6 mL. The difference between the predicted and actual treatment volumes was 72.2 ± 59.9 mL; it was not statistically significant (p = 0.8). Virtual Parenchymal Perfusion software can accurately predict treatment volumes during intra-arterial therapy.