scholarly journals Correction: Effectiveness of intraprocedural dual-phase cone-beam computed tomography in detecting hepatocellular carcinoma and improving treatment outcomes following conventional transarterial chemoembolization

PLoS ONE ◽  
2021 ◽  
Vol 16 (2) ◽  
pp. e0247648
Author(s):  
Keyword(s):  
Computed Tomography ◽  
Hepatocellular Carcinoma ◽  
Treatment Outcomes ◽  
Cone Beam Computed Tomography ◽  
Transarterial Chemoembolization ◽  
Cone Beam ◽  
Dual Phase

scholarly journals Effectiveness of intraprocedural dual-phase cone-beam computed tomography in detecting hepatocellular carcinoma and improving treatment outcomes following conventional transarterial chemoembolization

PLoS ONE ◽  
2021 ◽  
Vol 16 (1) ◽  
pp. e0245911 ◽  
Author(s):  
Youngjong Cho ◽  
Sangjoon Lee ◽  
Sung-Joon Park
Keyword(s):  
Computed Tomography ◽  
Hepatocellular Carcinoma ◽  
Treatment Outcomes ◽  
Cone Beam Computed Tomography ◽  
Cone Beam ◽  
Arterial Phase ◽  
Dual Phase ◽  
Mri Scans ◽  
Delayed Phase

To investigate the effectiveness of intraprocedural dual-phase cone-beam computed tomography (CBCT) in detecting hepatocellular carcinoma (HCC) during conventional transcatheter arterial chemoembolization (TACE) and its effect on improving treatment outcomes. Between November 2018 and November 2019, data from 111 patients with unresectable HCCs (N = 263 lesions) were reviewed retrospectively. All patients had undergone baseline magnetic resonance imaging (MRI) scans within one month prior to the procedure. Both arterial-phase (AP) and delayed-phase CBCT images were acquired during all conventional TACEs. Each HCC detection rate when read by AP-CBCT and when read by dual-phase (DP) CBCT including both AP and delayed phase was compared with that of MRI, and the diagnosis of HCC was based on MRI. Additionally, the follow-up results concerning lipiodol uptake status and tumor response of the lesions detected only by AP-/DP-CBCT were analyzed and compared with MRI-only detected lesions. The overall sensitivity of DP-CBCT (94.7%) was significantly higher than that of AP-CBCT (89.0%) (p = 0.003). In particular, the rate of subcentimeter HCC detection by DP-CBCT was pronounced (91.5% vs. 80.3%) (p = 0.01). Lesions found only by DP-CBCT exhibited positive lipiodol uptake (n = 31/31; 100%) and showed complete or partial responses (n = 24/31; 77.4%) on follow-up CT imaging, while MRI-only detected lesions had less lipiodol uptake (n = 6/14, 42.9%) and complete or partial responses (n = 4/14; 28.6%) (p ≤ 0.001). DP-CBCT imaging during TACE enabled better detection of HCCs than when using AP-CBCT alone, and AP- and DP-CBCT is superior to MRI in detecting chemoembolization-sensitive lesions. This resulted in increased detectability of HCCs and the achievement of better treatment outcomes.

scholarly journals Impact of cone-beam computed tomography with automated feeder detection software on the survival outcome of patients with hepatocellular carcinoma during treatment with conventional transarterial chemoembolization

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Kittipitch Bannangkoon ◽  
Keerati Hongsakul ◽  
Teeravut Tubtawee
Keyword(s):  
Computed Tomography ◽  
Hepatocellular Carcinoma ◽  
Cone Beam Computed Tomography ◽  
Transarterial Chemoembolization ◽  
Tumor Response ◽  
Progression Free Survival ◽  
Complete Response ◽  
Cone Beam ◽  
Free Survival ◽  
Factors Affecting

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.

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