Spiral computed tomography arterial portography with three-dimensional volumetric rendering for oncologic surgery planning: A retrospective analysis

Rationale and Objectives. Surgical resection of metastatic neoplasms of the liver can prolong survival of patients. The decision to resect a tumor depends to a great extent on the location of lesions relative to hepatic vasculature. Spiral computed tomography arterial portography (SCTAP) is an excellent technique for preoperative localization of tumors. The addition of three-dimensional rendering of image data sets should enhance the efficiency and accuracy of the interpretation of these data by the surgeon. Methods. Fourteen patients with surgically and pathologically proven solitary and multiple metastatic hepatic neoplasms underwent SCTAP. Volume data sets thus derived were used to produce life-like three-dimensional animated images through a process known as volumetric rendering. These images were presented to the surgeon, who evaluated them based on several criteria. Results. Accurate and clinically useful images were produced routinely in 13 of 14 patients. Conclusions. Clinical utility of three-dimensional rendering of SCTAP data sets for preoperative localization of hepatic lesions has been shown retrospectively. A larger, prospective study is suggested to demonstrate the accuracy and efficacy of the technique.