Abstract
Purpose
Retrograde superselective intra-arterial chemoradiotherapy is a radical treatment for advanced oral cancer. The catheter tip is placed into tumor-feeding arteries—the lingual, facial, or maxillary arteries. The diameter of the tumor-feeding arteries newly bifurcated from the external carotid artery is crucial for determining the requirement of a catheter navigation system. This study aimed to measure the diameter and distribution of the tumor-feeding artery according to an objective protocol using 3D computed tomography angiography images reproducibly.
Methods
Angiographic data of 20 noncatheterized carotid arteriesof 10 randomly selected patients were analyzed. We followed the external carotid artery to the entrance of each feeding artery to determine the center point where the artery diameter was measured. The diameter of the optimum circle measured at the adopted center point was taken as the diameter of each tumor-feeding artery.
Results
The diameters (mean ± standard deviation) were 3.5 ± 0.45, 2.9 ± 0.56, and 3.5 ± 0.56 mm for the maxillary, lingual, and facial arteries, respectively. The diameters of the maxillary and facial arteries were similar (p = 0.877), whereas the diameter of the lingual artery was smaller than that of the maxillary and facial arteries (p < 0.001).
Conclusion
The findings of this study will be beneficial in determining the need of a new catheter navigation system and diameter of catheters to be used in the clinical practice. From the viewpoint of measurement automation and reproducibility, 3DCTA vessel measurement taken according to the proposed protocol was considered to be effective.
![](http://media.springernature.com/m312/springer-static/image/art%3A10.1007%2Fs11548-023-02992-1/MediaObjects/11548_2023_2992_Fig1_HTML.png)
![](http://media.springernature.com/m312/springer-static/image/art%3A10.1007%2Fs11548-023-02992-1/MediaObjects/11548_2023_2992_Fig2_HTML.png)
![](http://media.springernature.com/m312/springer-static/image/art%3A10.1007%2Fs11548-023-02992-1/MediaObjects/11548_2023_2992_Fig3_HTML.png)
References
Mitsudo K, Koizumi T, Iida M, Iwai T, Nakashima H, Oguri S, Kioi M, Hirota M, Koike I, Hata M, Tohnai I (2014) Retrograde superselective intra-arterial chemotherapy and daily concurrent radiotherapy for stage III and IV oral cancer: analysis of therapeutic results in 112 cases. Radiother Oncol 111:306–310. https://doi.org/10.1016/j.radonc.2014.03.005
Mitsudo K, Koizumi T, Iida M, Iwai T, Oguri S, Yamamoto N, Itoh Y, Kioi M, Hirota M, Tohnai I (2012) Thermochemoradiation therapy using superselective intra-arterial infusion via superficial temporal and occipital arteries for oral cancer with N3 cervical lymph node metastases. Int J Radiat Oncol Biol Phys 83:e639–e645. https://doi.org/10.1016/j.ijrobp.2012.02.057
Hayashi Y, Mitsudo K, Sakuma K, Iida M, Iwai T, Nakashima H, Okamoto Y, Koizumi T, Oguri S, Hirota M, Kioi M, Koike I, Hata M, Tohnai I (2017) Clinical outcomes of retrograde intra-arterial chemotherapy concurrent with radiotherapy for elderly oral squamous cell carcinoma patients aged over 80 years old. Radiat Oncol 12:112. https://doi.org/10.1186/s13014-017-0847-3
Nozato T, Koizumi T, Hayashi Y, Iida M, Iwai T, Oguri S, Hirota M, Kioi M, Koike I, Hata M, Tohnai I, Mitsudo K (2019) Thermochemoradiotherapy using superselective intra-arterial infusion for patients with oral cancer with cervical lymph node metastases. Anticancer Res 39:1365–1373. https://doi.org/10.21873/anticanres.13250
Fuwa N, Kodaira T, Furutani K, Tachibana H, Nakamura T (2008) A new method of selective intra-arterial infusion therapy via the superficial temporal artery for head and neck cancer. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 105:783–789. https://doi.org/10.1016/j.tripleo.2007.07.031
Wang J, Ohya T, Liao H, Sakuma I, Wang T, Tohnai I, Iwai T (2011) Intravascular catheter navigation using path planning and virtual visual feedback for oral cancer treatment. Int J Med Robot 7:214–224. https://doi.org/10.1002/rcs.392
Ohya T, Iwai T, Luan K, Kato T, Liao H, Kobayashi E, Mitsudo K, Fuwa N, Kohno R, Sakuma I, Tohnai I (2012) Analysis of carotid artery deformation in different head and neck positions for maxillofacial catheter navigation in advanced oral cancer treatment. Biomed Eng Online 11:65. https://doi.org/10.1186/1475-925X-11-65
Luan K, Ohya T, Liao H, Kobayashi E, Sakuma I (2013) Vessel bifurcation localization based on intraoperative three-dimensional ultrasound and catheter path for image-guided catheter intervention of oral cancers. Comput Med Imaging Graph 37:113–122. https://doi.org/10.1016/j.compmedimag.2013.01.007
Yanagida K, Ohya T, Wang J, Iwai T, Izumi T, Kobayashi E, Sakuma I, Mitsudo K (2021) Applicability of a single camera-based catheter navigation system using teeth arch as an anatomical landmark for superselective intraarterial infusion in advanced oral cancer treatment. Med Biol Eng Comput 59:663–672. https://doi.org/10.1007/s11517-021-02326-w
Wood BJ, Zhang H, Durrani A, Glossop N, Ranjan S, Lindisch D, Levy E, Banovac F, Borgert J, Krueger S, Kruecker J, Viswanathan A, Cleary K (2005) Navigation with electromagnetic tracking for interventional radiology procedures: a feasibility study. J Vasc Interv Radiol 16:493–505. https://doi.org/10.1097/01.RVI.0000148827.62296.B4
Krücker J, Xu S, Glossop N, Viswanathan A, Borgert J, Schulz H, Wood BJ (2007) Electromagnetic tracking for thermal ablation and biopsy guidance: clinical evaluation of spatial accuracy. J Vasc Interv Radiol 18:1141–1150. https://doi.org/10.1016/j.jvir.2007.06.014
Condino S, Ferrari V, Freschi C, Alberti A, Berchiolli R, Mosca F, Ferrari M (2012) Electromagnetic navigation platform for endovascular surgery: how to develop sensorized catheters and guidewires. Int J Med Robot 8:300–310. https://doi.org/10.1002/rcs.1417
Nagano R, Hara K, Kobayashi E, Ohya T, Sakuma I (2023) A pilot study on an electromagnetic tracking system using tunneling magnetoresistance (TMR) sensors applicable to a 4F catheter (1.4 mm in diameter). Int J Comput Assist Radiol Surg 18:17–27. https://doi.org/10.1007/s11548-022-02746-5
Kitajima H, Oshima M, Iwai T, Ohhara Y, Yajima Y, Mitsudo K, Tohnai I (2017) Computational fluid dynamics study of intra-arterial chemotherapy for oral cancer. Biomed Eng Online 16:57. https://doi.org/10.1186/s12938-017-0348-5
Acar M, Salbacak A, Sakarya ME, Zararsiz I, Ulusoy M (2013) The morphometrical analysis of the external carotid artery and its branches with multidetector computerized tomography angiography technique. Int J Morphol 31:1407–1414. https://doi.org/10.4067/S0717-95022013000400042
Acknowledgements
This study was funded by the Japan Society for the Promotion of Science KAKENHI (JP20H04553). The authors would like to thank Enago (www.enago.jp) for the manuscript review and editing support.
Author information
Authors and Affiliations
Contributions
All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by TO. The first draft of the manuscript was written by TO and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.
Corresponding author
Ethics declarations
Conflict of interest
The authors declare that they have no conflicts of interest.
Ethical approval
All procedures performed in studies involving human data were in accordance with the ethical standards of the Institutional and National Research Committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed consent
We applied the opt-out method to obtain consent.
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
Ohya, T., Sakuma, I., Cai, W. et al. Diameters of lingual, facial, and maxillary arteries measured according to an objective protocol on 3D computed tomography angiography images. Int J CARS 19, 303–308 (2024). https://doi.org/10.1007/s11548-023-02992-1
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11548-023-02992-1