Ken Takada1, Hidenori Toyoda2, Toshifumi Tada3, Takanori Ito3, Ryohei Hasegawa3, Tatsuya Gotoh1, Hironori Ichikawa1, Yasuhiro Sone4, Takashi Kumada3. 1. Department of Medical Technology, Ogaki Municipal Hospital, 4-86 Minaminokawa, Ogaki, Gifu, 503-8502, Japan. 2. Department of Gastroenterology, Ogaki Municipal Hospital, 4-86 Minaminokawa, Ogaki, Gifu, 503-8502, Japan. hmtoyoda@spice.ocn.ne.jp. 3. Department of Gastroenterology, Ogaki Municipal Hospital, 4-86 Minaminokawa, Ogaki, Gifu, 503-8502, Japan. 4. Department of Radiology, Ogaki Municipal Hospital, 4-86 Minaminokawa, Ogaki, Gifu, 503-8502, Japan.
Abstract
BACKGROUND: Transarterial chemoembolization (TACE) is an important treatment modality for hepatocellular carcinoma (HCC). Accurate identification of feeding arteries and catheterization are necessary for achieving treatment efficacy, especially with selective TACE. However, this often requires multiple imaging studies. We evaluated the utility of a newly developed apparatus that combines multidetector-row computed tomography (MDCT) and angiography (angio-MDCT) to facilitate TACE for treatment of HCC. METHODS: A total of 73 patients who underwent selective TACE with angio-MDCT were compared with 57 patients who had undergone selective TACE with single-row computed tomography assisted by angiography (angio-CT) in terms of the number of imaging studies needed to complete TACE. RESULTS: The mean number of digital subtraction arteriography (DSA) and CT studies required for characterization of feeding arteries before embolization was 3.53 (range 1-8) and 5.16 (range 2-11), respectively, with single-row angio-CT, and 1.67 (range 1-5) and 2.90 (range 1-5), respectively, with angio-MDCT. Fewer studies were needed in patients who underwent TACE with angio-MDCT (p < 0.0001 for both DSA and CT). Whereas single-row angio-CT failed to identify extrahepatic feeders in three patients (37.5%), all extrahepatic feeders could be identified with angio-MDCT. CONCLUSIONS: Angio-MDCT facilitates rapid and accurate identification of feeding arteries in patients undergoing TACE through the three-dimensional image analyses by the reconstruction with the workstation.
BACKGROUND: Transarterial chemoembolization (TACE) is an important treatment modality for hepatocellular carcinoma (HCC). Accurate identification of feeding arteries and catheterization are necessary for achieving treatment efficacy, especially with selective TACE. However, this often requires multiple imaging studies. We evaluated the utility of a newly developed apparatus that combines multidetector-row computed tomography (MDCT) and angiography (angio-MDCT) to facilitate TACE for treatment of HCC. METHODS: A total of 73 patients who underwent selective TACE with angio-MDCT were compared with 57 patients who had undergone selective TACE with single-row computed tomography assisted by angiography (angio-CT) in terms of the number of imaging studies needed to complete TACE. RESULTS: The mean number of digital subtraction arteriography (DSA) and CT studies required for characterization of feeding arteries before embolization was 3.53 (range 1-8) and 5.16 (range 2-11), respectively, with single-row angio-CT, and 1.67 (range 1-5) and 2.90 (range 1-5), respectively, with angio-MDCT. Fewer studies were needed in patients who underwent TACE with angio-MDCT (p < 0.0001 for both DSA and CT). Whereas single-row angio-CT failed to identify extrahepatic feeders in three patients (37.5%), all extrahepatic feeders could be identified with angio-MDCT. CONCLUSIONS: Angio-MDCT facilitates rapid and accurate identification of feeding arteries in patients undergoing TACE through the three-dimensional image analyses by the reconstruction with the workstation.
Authors: Elliot K Fishman; Derek R Ney; David G Heath; Frank M Corl; Karen M Horton; Pamela T Johnson Journal: Radiographics Date: 2006 May-Jun Impact factor: 5.333