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CCC (Circular Color Coding) versus Parametric Color
Imaging:Which one wins for shunt point detectability in dural
arteriovenous fistulae?
Tetsu Satow1, Satoru Oishi2, Masanobu Yamada3, Hiromichi
Yokoyama3, and Jun C Takahashi11Department of Neurosurgery,
National Cerebral and Cardiovascular Center, Osaka, JAPAN2Research
and Development Center, Toshiba Medical Systems Corporation,
Tochigi, JAPAN1Department of Radiology, National Cerebral and
Cardiovascular Center, Osaka, JAPANASNR 2015 annual meeting April
27, 2015@Chicago
Poster ID: EP-107-2467Control #: 1712Financial DisclosuresSatoru
Oishi is an employee of Toshiba Medical Systems Corporation.Other
authors have no financial or other relations that could lead to
conflicts of interest. 2Introduction In treating dural AVFs, the
therapeutic goal is to occlude the dural vein close to the shunt
point, whether by TAE or TVE. Thus, the detection of the shunt
point is crucial in executing intervention. And we have presented a
novel angiographic tool named CCC (circular color coding) which is
a sequential, color-coded angiograms in preceding ASNR meeting
(EP-54).
CCC(Circular Color Coding)
PurposeTo prove that CCC is more useful in detecting shunts of
dural arteriovenous fistulae (dAVF) compared with parametric color
coding images (time-to-peak: TTP)1)2). Strother et al. AJNR
2010Goelitz et al. Clin Neuroradiol 2013CCC vs DSA/TTP
CCCDSATTP (still image)Click the image to Activate the
movieClick the image to Activate the movieMaterials and Methods
(1)A total of 19 DSA acquisitions from dAVFs (cavernous sinus: 4,
transverse-sigmoid: 13, superior sagittal sinus : 2) were used.
DSA, TTP images, and CCC were prepared.
8 physicians (4 experienced, certified neuroendovascular
therapists: NET, and 4 younger neurosurgeons) were selected as
readers.
They were divided into two groups (A and B) so as to include two
experienced and younger physicians.7Materials and Methods (2)For
group A, DSA sequence and TTP image were initially presented, and
the observer was asked to answer the location(s) of shunt point and
patterns of venous drainage. After viewing all 19 sets, CCC
sequence of each case was presented in a randomized order, and the
observer was asked again as to the shunt location and venous
drainage.For group B, the same questionnaire were performed
although they were initially exposed to CCC, followed by DSA/TTP
combination.
The time to detection for each case was also recorded.8Group A2
experienced NET2 young neurosurgeons CCCShunt point
detectionPatterns of venous drainageTime to detectionGroup B2
experienced NET2 young neurosurgeons DSA/TTPCCCDSA/TTPFlowchart of
the studyOverall Results (19 cases@8
readers=152)AccuracyDSA+TTPCCC2detecting all the
shunts521241detecting some of the shunts73250none detected273Shunt
detectionAccuracyDSA+TTPCCC2detecting all drainage
routes1191441detecting some of the routes3080none
detected30Recognition of venous drainage patternsP