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A Major Breakthrough in Vascular Visualization: Two New Applications for Interventional Procedures

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At the European Congress of Radiology in Vienna, Austria, this week, GE Healthcare introduced two new vascular visualization software applications that give  interventional radiologists more complete and detailed information.

Described as a major breakthrough, FlightPlan for Liver automatically extracts vessels in the vicinity of the tumor during liver embolizations, while AngioViz enhances Digital Subtraction Angiography (DSA) to give a new vision of vascular flow. Both solutions aim to highlight vasculature nearby liver tumors while embolizations are taking place. 

Being the fifth most common cancer for men, and the eighth most common for women, liver cancer cases are more than 749,000 per year globally. High doses of cancer-killing drugs (chemotheraphy) are delivered directly to the organ while the tumor is deprived of its blood supply by blocking, or embolizing, the arteries feeding the tumor; an interventional oncology procedure known as "Chemoembolization".  Approximately half of all interventional oncology procedures in the liver are this type.

Because the liver arterial tree is highly complex, navigating catheters to a precise target in that vascular structure can be difficult and time consuming. Moreover, identifying the vessels can take significant time, radiation exposure and contrast material. This is exactly where FlightPlan for Liver is used.

FlightPlan is a user-friendly, powerful application that helps the radiologist to plan and perform liver embolization. With FlightPlan, the success rate in detecting tumor-feeding vessels is 93%, as compared to 64% and 73% when using 2D and 3D review, respectively.

FlightPlan For Liver automatic identification of feeders in the vicinity of the tumor allows to delegate most of the processing to the staff in the control room and accelerate the understanding of the tumor anatomy. It works by building up the vascular tree, in 3D, from a chosen point in the hepatic artery. After which,  the radiologist selects the tumor area, and in a single click FlightPlan automatically extracts the vessels in the vicinity of the tumor and displays them with color-coding for easy visualization. Thanks to the information provided by FlightPlan, the radiologist can more easily identify the tumor-feeding vessels and be more selective when planning the embolization. 

A real help that improves workflow and provides more confidence.

The second new innovation from GE, AngioViz, is an application that provides a new visualization of the vascular flow seen in Digital Subtraction Angiography (DSA). DSA uses image intensifiers to digitize images of injected contrast and removes the under and overlying body structures by digitally subtracting an image taken before the contrast was injected. Used with today's modern digital flat panel X-ray detectors, this technique produces excellent images of vascular anatomy.

But doctors need more than vascular anatomy, like more information about the patterns and amount of blood flow to make better decisions during image guided interventions. They also want to have temporal information on one image, instead of having to scan through a series of DSA images. Finally, they want to see how the flow of blood to an area of tissue has changed as a result of treatment.

Here comes the role of AngioViz. The new application provides a new visualization of the vascular flow seen in DSA, called parametric imaging. It determines for each pixel, the time it takes to reach peak opacification and the peak value of opacification. These two parameters can be displayed as separate images or combined in several ways in a single color-coded image.

This enables doctors to perceive both temporal and contrast intensity information in a single image, in addition to reviewing the whole temporal DSA sequence to see the information. In addition, AngioViz allows easy comparison of parametric images from different DSA acquisitions, such as pre- and post-treatment images, or right and left cerebral hemisphere images. This can help physicians understand the impact on flow dynamics of various interventional treatments.

At this time, AngioViz and FlightPlan for Liver are not cleared or approved by the U.S. Food and Drug Administration for commercial availability in the U.S. nor is cleared and approved for commercial availability in Canada, China, Japan, Taiwan, South Korea, and Ethiopia.

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