Transcatheter hepatic subsegmental arterial chemoembolization therapy using iodized oil for small hepatocellular carcinomas. Correlation between lipiodol accumulation pattern and local recurrence.

Lipiodol accumulation patterns were correlated with local recurrences after subsegmental or conventional arterial chemoembolization therapy using iodized oil (Lipiodol-TAE). Thirty-six patients with solitary small hepatocellular carcinomas (HCCs) less than 3 cm in diameter were included in this retrospective study. Superselective subsegmental catheterization was performed in 14 patients (subsegmental Lipiodol-TAE). In the remaining 22 cases, embolization was performed from the proximal portion of the hepatic artery (conventional Lipiodol-TAE). Patterns of Lipiodol accumulations within the tumors were classified in 2 groups: complete and incomplete accumulation. Complete accumulation was observed in 71% of subsegmental Lipiodol-TAE and in 32% of conventional Lipiodol-TAE. The rate of local recurrences within 12 months was significantly higher (p < 0.01) in incomplete accumulation (100%) than in complete accumulation (13%). We suggest that when small HCCs are to be treated with TAE, subsegmental Lipiodol-TAE should be performed because of its superior capability for achieving complete Lipiodol accumulation.