.png){kind=icon}
.png){kind=icon}
Return
Nonselective Intra-arterial CT Angiography Versus Selective Digital Subtraction Angiography for Detecting Neovascularization During Transarterial Embolization for Adhesive Capsulitis
.png){kind=icon}
PRE
AI
DOI：10.1007/s00270-026-04533-0.png)
.png){kind=icon}
Original request for help.png){kind=icon}
Share.png){kind=icon}
Save
Abstract
En 中文
Transarterial embolization (TAE) for adhesive capsulitis requires precise detection of periarticular neovascularization, which is often inconspicuous on digital subtraction angiography (DSA). This study compared intra-arterial CT angiography (IA-CTA) with DSA for detecting synovial neovascularization during embolization. In this prospective single-center study, 21 participants with adhesive capsulitis despite ≥ 3 months of conservative treatment were enrolled. Nonselective IA-CTA was performed from the mid-subclavian artery before selective DSA-guided embolization in a hybrid angio-CT suite. Six periarticular sites per shoulder were evaluated. Two radiologists independently assigned five-point scores for IA-CTA and DSA to establish the reference standard using a multimodality adjudication rule. Six radiology residents independently scored each modality. Diagnostic performance was compared using multireader multicase analysis; secondary endpoints were sensitivity, specificity, and reader agreement. Twenty-one participants (mean age, 61.6 ± 11.0 years; 15 women, 6 men) were included. Of 126 periarticular sites, 65 (51.6%) were positive by the reference standard. Reader-averaged area under the receiver operating characteristic curve (AUC) favored IA-CTA over DSA (0.901 vs. 0.769; p < 0.01). At the prespecified positivity threshold (score ≥ 4), reader-averaged sensitivity was 68.5% (95% CI: 57.0–79.7) with IA-CTA and 47.9% (95% CI: 36.9–57.7) with DSA (p = 0.01), whereas specificity was 95.4% (95% CI: 90.8–99.0) with IA-CTA and 92.3% (95% CI: 86.2–97.4) with DSA (p = 0.24). Inter-reader agreement favored IA-CTA over DSA (weighted κ 0.75 vs. 0.65; p < 0.01). Nonselective IA-CTA showed higher diagnostic performance, higher sensitivity, and better inter-reader agreement than selective DSA for detecting synovial neovascularization. Level 4, diagnostic study. (ClinicalTrials.gov: NCT06509087)
Keywords:
Shoulder
Adhesive capsulitis
Transarterial embolization
Digital subtraction angiography
Computed tomography angiography
Journal
IF:
2.9
Papers:
609
Citations:
7.3K
Organization
View more organizations