Non-contrast chest CT 3D reconstruction reduced the absolute deviation from optimal catheter depth (|ΔL|) to 0.70 cm compared to 1.00 cm by IC-ECG guidance in female breast cancer patients undergoing TIVAP placement.
Cross-Sectional (n=50)
No
Does preoperative 3D reconstruction improve the accuracy of predicting optimal catheter insertion depth compared to IC-ECG in female breast cancer patients undergoing TIVAP placement?
Non-contrast chest CT 3D reconstruction provides greater absolute accuracy in preoperative depth prediction for TIVAP placement compared to IC-ECG, offering a viable alternative when intraoperative guidance is unavailable.
Estimación del efecto: p=0.007 for |ΔL| absolute deviation difference
Tasa de eventos absoluta: 0.7% vs 1%
valor p: p=0.007
Precise positioning of the catheter tip at the cavoatrial junction (CAJ) is critical for totally implantable venous access port (TIVAP) safety; however, it remains technically challenging. Here, we propose a novel preoperative method using non-contrast chest computed tomography (CT)-based three-dimensional (3D) reconstruction to predict insertion depth. In this retrospective matched-pairs study, 50 female patients with breast cancer who underwent right/left jugular TIVAP placement were analyzed. The vascular centerline of the cervicothoracic vein from the clavicular to the right inferior pulmonary vein was reconstructed using 3D Slicer. The predicted catheter depth was compared with intracavitary electrocardiogram (IC-ECG) using signed (ΔL) and absolute distance (|ΔL|). The optimal depth was radiographically confirmed at 2.4 vertebral body units below the carina. There was no significant difference in ΔL between the two methods (-0.49 cm vs. -0.82 cm, p = 0.056). The 3D reconstruction achieved significantly smaller |ΔL| values than IC-ECG (0.70 cm vs. 1.00 cm, p = 0.007), while the 3D reconstruction ΔL showed no correlations with anthropometric factors (p > 0.05). Non-contrast chest CT 3D reconstruction shows greater accuracy in preoperative depth prediction compared to IC-ECG. It may thus be a preferential alternative when intraoperative guidance is unavailable.
Lin et al. (Wed,) conducted a cross-sectional in Female patients with primary breast cancer undergoing totally implantable venous access port (TIVAP) placement via internal jugular vein access for adjuvant chemotherapy (n=50). Non-contrast chest CT-based three-dimensional (3D) reconstruction catheter depth prediction vs. Intracavitary electrocardiogram (IC-ECG)-guided catheter depth prediction was evaluated on Difference in catheter tip insertion depth accuracy compared to optimal catheter depth at cavoatrial junction (CAJ) confirmed by chest X-ray (p=0.007 for |ΔL| absolute deviation difference, p=0.007). Non-contrast chest CT 3D reconstruction reduced the absolute deviation from optimal catheter depth (|ΔL|) to 0.70 cm compared to 1.00 cm by IC-ECG guidance in female breast cancer patients undergoing TIVAP placement.