scholarly journals Utility of C-Arm CT in Detection Hepatocellular Carcinoma during Trans Arterial Chemoembolization

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
M S Ghazy ◽  
A H Soliman ◽  
M H K Abdelmaksoud ◽  
N M E Morsy
Keyword(s):  
Hepatocellular Carcinoma ◽  
Gold Standard ◽  
Transcatheter Arterial Chemoembolization ◽  
Cone Beam Ct ◽  
Clinical History ◽  
Cone Beam ◽  
Success Rates ◽  
Feeding Vessels ◽  
Ct Technology ◽  
Arterial Chemoembolization

Abstract Background Transcatheter arterial chemoembolization is one of the effective therapeutic options for hepatocellular carcinoma (HCC). Ultraselective chemoembolization is an alternative approach to improve local control, and is associated with a reduced incidence of adverse effects. Objective It was to evaluate the sensitivity of cone beam computed tomography (CBCT) in detecting HCC tumors and their feeding vessels during transarterial chemoembolization (TACE). Patients and Methods All patients were suspected of having or confirmed to have HCC on the basis of clinical history, underlying liver disease and/or viral infection, the diagnosis of HCC was made by imaging findings. Between January 2016 and January 2018, Dyna CT was retrospectively used in 19 consecutive patients with HCC tumor with HCC tumor. Results The detectability of the tumor with DSA obtained at the common, proper, right, or left hepatic artery (i.e., nonselective DSA) and cone-beam CT was compared as taking pre imaging as a gold standard. Tumor stain and feeding branches were evaluated. The detectability of the tumor-feeding branch with non-selective DSA and Dyna CT HA images was compared. Conclusion Tumor detectability on cone-beam CT was significantly greater than on non-selective. Cone beam HA taking pre imaging as a gold standard was (94.4%) and its specificity (71.6%) with accuracy (76.97%). The sensitivity of DSA in detection of additional tumor as taking the pre imaging (CT/MRI) as a gold standard was (88.9%) and its specificity (84.5%) with accuracy (85.53%). Cone-beam CT has satisfactory ability to detect tumors; the detectability of tumor-feeding branches with Dyna CT was significantly higher than that with nonselective DSA (P less than 0.001). We believe the technical success rates of ultraselective transcatheter arterial chemoembolization may be improved by chemoembolization guidance software that uses cone-beam CT technology.

Hemodynamic Changes on Cone-Beam Computed Tomography during Balloon-Occluded Transcatheter Arterial Chemoembolization Using Miriplatin for Hepatocellular Carcinoma: A Preliminary Study

2017 ◽  
Vol 35 (6) ◽  
pp. 598-601 ◽  
Author(s):  
Toru Ishikawa ◽  
Michitaka Imai ◽  
Takashi Owaki ◽  
Hiroki Sato ◽  
Yujiro Nozawa ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Transcatheter Arterial Chemoembolization ◽  
Cone Beam Ct ◽  
Balloon Occlusion ◽  
Cone Beam ◽  
Hemodynamic Changes ◽  
Hepatic Arteriography ◽  
New Strategy ◽  
Preliminary Study ◽  
Arterial Chemoembolization

Background/Aim: Balloon-occluded transcatheter arterial chemoembolization (B-TACE) using miriplatin (MPT) is anticipated as a new strategy for hepatocellular carcinoma (HCC). This study was aimed at evaluating the hemodynamic changes with/without balloon occlusion of the hepatic artery, correlation of cone-beam CT (CBCT) pixels, and CT value after B-TACE for HCC. Methods: A total of 52 patients with HCC, who underwent B-TACE using MPT in addition to the balloon-occluded CBCT hepatic arteriography, were studied. Results: After balloon occlusion, CBCT pixel values increased in 37 lesions, whereas it decreased in 15 lesions. Intratumoral CT values after B-TACE were lower with decreased CBCT pixel values than with increased CBCT pixel values. Conclusion: Hemodynamic changes on CBCT during balloon occlusion can be used to predict the efficacy of B-TACE using MPT.

scholarly journals Comparison of the effectiveness of celiac versus common hepatic artery injection for the detection of hepatocellular carcinoma and of the feeding artery on cone-beam computed tomographs obtained during hepatic angiography

2021 ◽  
Vol 10 (2) ◽  
pp. 205846012199473
Author(s):  
Akihiro Hotta ◽  
Masaki Ishikawa ◽  
Toshihiro Tachikake ◽  
Noriaki Matsuura ◽  
Naoyuki Toyota ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Hepatic Artery ◽  
Transcatheter Arterial Chemoembolization ◽  
Common Hepatic Artery ◽  
Cone Beam ◽  
Feeding Artery ◽  
Branch Order ◽  
Hepatocellular Carcinomas ◽  
Artery Branch ◽  
Arterial Chemoembolization

Background Cone-beam computed tomography (CBCT) has been widely used during transcatheter arterial chemoembolization for hepatocellular carcinoma. Purpose To evaluate the sensitivity of CBCT for the detection of hepatocellular carcinomas and the tumor feeders by comparing celiac artery (CA) and common hepatic artery (CHA) injection. Material and methods We retrospectively enrolled 30 patients (52 hepatocellular carcinoma lesions) who had undergone CBCT-assisted transcatheter arterial chemoembolization. In 17 procedures (28 hepatocellular carcinomas) we acquired CBCT scans using CA injections (CBCT-CA) and in 18 (24 hepatocellular carcinomas) we used CHA injections (CBCT-CHA). Of the 30 patients, 5 underwent CBCT-CA and CBCT-CHA at different transcatheter arterial chemoembolization procedures. We performed inter-group comparisons of the detectability of hepatocellular carcinoma, the feeding artery, the intrahepatic artery branch order, and the tumor-to-liver contrast. Results CBCT-CA detected all 28 hepatocellular carcinomas and 27 of their feeders (96.4%); CBCT-CHA identified 22 of 24 hepatocellular carcinomas (91.7%) and 21 of their feeders (95.5%). There was no significant inter-group difference in the detectability of hepatocellular carcinoma lesions (p = 0.21) or feeding arteries (p = 0.69). CBCT-CHA was superior for the assessment of the tumor-to-liver contrast and the intrahepatic artery branch order (both: p < 0.01). Conclusion CBCT-CA and CBCT-CHA were equally useful for the detection of hepatocellular carcinoma and of the feeding artery, although CBCT-CHA yields better visualization of hepatocellular carcinoma and the hepatic artery. Thus CA injection seems sufficient for lesion and vessel detection when the insertion of an angiographic catheter into the CHA is difficult.

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