Early prediction of 1-year tumor response of hepatocellular carcinoma with lipiodol deposition pattern through post-embolization cone-beam computed tomography during conventional transarterial chemoembolization

Author(s):  
Yin-Chen Tsai ◽  
Jou-Ho Shih ◽  
Hsuen-En Hwang ◽  
Nai-Chi Chiu ◽  
Rheun-Chuan Lee ◽  
...  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Kittipitch Bannangkoon ◽  
Keerati Hongsakul ◽  
Teeravut Tubtawee

Abstract Background Inoperable hepatocellular carcinoma (HCC) is treated by conventional transarterial chemoembolization (cTACE) using cone-beam computed tomography (CBCT) or digital subtraction angiography (DSA). We compared patient survival outcomes between CBCT-cTACE with automated tumor-feeder detection (AFD) software and DSA-cTACE alone in inoperable HCC patients. Methods We reviewed the data of 337 HCC patients treated by CBCT-cTACE or DSA-cTACE between January 2015 and December 2019. Treatment response, progression-free survival (PFS), overall survival (OS), and complications between the CBCT-cTACE and DSA-cTACE groups were compared. Univariate and multivariate logistic regression analyses examined the potential prognostic factors affecting survival after chemoembolization. Results Tumor response rates in complete response, partial response, and stable disease at 1 month were 67%, 28%, and 4% in the CBCT-cTACE group and 22%, 48%, and 9% in the DSA-cTACE group, respectively. OS rates of patients in the CBCT-cTACE versus DSA-cTACE groups were 87% versus 54%, 44% versus 15%, and 34% versus 7% at 1, 3, and 5 years, respectively. The CBCT-cTACE group had significantly improved PFS (p < 0.001) and OS (p < 0.001). Multivariate analysis showed that CBCT with AFD software was an independent factor associated with longer OS (hazard ratio, 0.38; p < 0.001). Conclusions Compared with conventional DSA, combining selective cTACE with CBCT and AFD software leads to better tumor response and prolongs OS in patients with inoperable HCC.


2021 ◽  
Author(s):  
Kitttipitch Bannangkoon ◽  
Keerati Hongsakul ◽  
Teeravut Tubtawee

Abstract Background Inoperable hepatocellular carcinoma (HCC) is treated by transarterial chemoembolization (TACE) using cone-beam computed tomography (CBCT) or digital subtraction angiography (DSA). We compared patient survival outcomes between CBCT-TACE with automated tumor-feeder detection (AFD) software and DSA-TACE alone in inoperable HCC patients. Methods We reviewed the data of 337 HCC patients treated by CBCT-TACE or DSA-TACE between January 2015 and December 2019. Treatment response, progression-free survival (PFS), overall survival (OS), and complications between the CBCT-TACE and DSA-TACE groups were compared. Univariate and multivariate logistic regression analyses examined the potential prognostic factors affecting survival after chemoembolization. Results Tumor response rates in complete response, partial response, and stable disease at 1 month were 67%, 28%, and 4% in the CBCT-TACE group and 22%, 48%, and 9% in the DSA-TACE group, respectively. OS rates of patients in the CBCT-TACE vs DSA-TACE groups were 87% vs. 54%, 44% vs. 15%, and 34% vs. 7% at 1, 3, and 5 years, respectively. The CBCT-TACE group had significantly improved PFS (p < 0.001) and OS (p < 0.001). Multivariate analysis showed that CBCT with AFD software was an independent factor associated with longer OS (hazard ratio, 0.38; p < 0.001). Conclusions Compared with conventional DSA, combining selective TACE with CBCT and AFD software leads to better tumor response and prolongs OS in patients with inoperable HCC.


2016 ◽  
Vol 50 (4) ◽  
pp. 418-426 ◽  
Author(s):  
Peter Popovic ◽  
Borut Stabuc ◽  
Rado Jansa ◽  
Manca Garbajs

Abstract Background The purpose of this retrospective study was to evaluate treatment response, adverse events and survival rates of patients with intermediate stage HCC treated with superselective doxorubicin-loaded DC Bead transarterial chemoembolization (DEBDOX) under cone beam computed tomography (CBCT) control. Patients and methods Between October 2010 and June 2012, 35 consecutive patients with intermediate stage HCC (32 male, 3 female; average age, 67.5 ± 7.8 years; 22 patients Child-Pugh class A, 8 class B, 5 without cirrhosis) were treated with DEBDOX TACE. Portal vein thrombosis was observed in 6 (17.1%) patients. DEBDOX TACE was performed by superselective catheterization of feeding vessels followed by embolization with 100-300 μm microspheres loaded with 50-100 mg of doxorubicin. In all cases, CBCT was used during chemoembolization. Tumor response rates were defined according to mRECIST criteria. Results Overall, 120 procedures were performed (mean, 3.2 per patients). We treated 97 lesions with an average diameter of 4.9 ± 1.9 cm. There were 32 minor and 2 (1.6%) major complications (one liver abscess and one cerebrovascular insult). After a mean follow-up of 27.7 ± 10.5 months, 94.3% of patients achieved an objective response to treatment (42.4% complete response and 57.6% partial response). Mean time to progression was 10.9 ± 5.3 months. Mean overall survival was 33.9 months (95% CI; 28.9 – 38.9 months), with 1- and 2- year survival of 97.1% and 65.7%, respectively. Conclusions Superselective DEBDOX TACE performed under CBCT control is a safe and effective method with high rates of tumor response and overall survival.


Author(s):  
Ibraheim Ahmed Diab ◽  
Shaimaa Abdel-hamid Hassanein ◽  
Hala Hafez Mohamed

Abstract Background Hepatocellular carcinoma (HCC) is the most common primary hepatic malignancy of adults. One of the established treatment procedures performed worldwide for HCC is transcatheter arterial chemoembolization (TACE). By using conventional angiography in TACE, we can detect and identify the vascular anatomy of the liver through obtaining 2D images. Recently C-arm cone beam computed tomography (CBCT) is introduced for obtaining cross-sectional and three-dimensional (3D) images for better visualization of small tumors and their feeding arteries. Results The number of detected focal lesions by angiography was 51 compared to 87 focal lesion detected by CBCT; of those, 45 and 77 were active lesions by both procedures respectively. For lesions, less than 1 cm CBCT detected 23 lesions while angiography detected only one lesion. Angiography detected 87 feeding arterial branch while cone beam CT-HA detected 130 branches to the same number of target lesion. Feeder tractability and confidence were better by CBCT. Conclusion CBCT is superior to angiography in tumor detectability, detection of lesions less than 1 cm, feeder detection, and feeder traction; however, conventional angiography and DSA are irreplaceable. Thus, combination of CBCT with angiography during TACE produces better results and less complication.


Oncology ◽  
2017 ◽  
Vol 92 (3) ◽  
pp. 142-152 ◽  
Author(s):  
Keizo Kato ◽  
Hiroshi Abe ◽  
Makiko Ika ◽  
Takeshi Yonezawa ◽  
Yoshiyuki Sato ◽  
...  

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