Digital variance angiography (DVA), a recently developed image processing technology,
provided higher contrast-to-noise ratio (CNR) and better image quality (IQ) during
lower limb interventions than digital subtraction angiography (DSA). Our aim was to
investigate whether this quality improvement can be observed also during liver transarterial
chemoembolization (TACE).We retrospectively compared the CNR and IQ parameters of
DSA and DVA images from 25 patients (65% male, mean ± SD age: 67.5 ± 11.2 years) underwent
TACE intervention at our institute. CNR was calculated on 50 images. IQ of every image
set was evaluated by 5 experts using 4-grade Likert scales. Both single image evaluation
and paired image comparison were performed in a blinded and randomized manner. The
diagnostic value was evaluated based on the possibility to identify lesions and feeding
arteries.DVA provided significantly higher CNR (mean CNRDVA/CNRDSA was 1.33). DVA
images received significantly higher individual Likert score (mean ± SEM 3.34 ± 0,08
vs. 2.89 ± 0.11, Wilcoxon signed-rank p < 0.001) and proved to be superior also in
paired comparisons (median comparison score 1.60 [IQR:2.40], one sample Wilcoxon p
< 0.001 compared to equal quality level). DSA could not detect lesion and feeding
artery in 28 and 36% of cases, and allowed clear detection only in 22% and 16%, respectively.
In contrast, DVA failed only in 8 and 18% and clearly revealed lesions and feeding
arteries in 32 and 26%, respectively.In our study, DVA provided higher quality images
and better diagnostic insight than DSA; therefore, DVA could represent a useful tool
in liver TACE interventions.III Non-consecutive study.
