OBJECTIVETo work out an individualized lipiodol dose in transcatheter arterial chemoembolization (TACE) for large hepatic carcinoma (HCC) according to its blood supply evaluated by CT.

METHODSOne hundred patients with HCC (diameter more than 8 cm) were studied by triphasic 5-mm-thick-section scan of multidetector helical CT. Patterns of HCC blood supply were divided into sufficient blood supply, poor blood supply, mixed blood supply and arterial-venous shunt. The dose of ultra-fluid lipiodol was determined by diameter and blood supply type of HCC. The patients were divided two groups (50 cases each), with the lipiodol perfused according to the diameter and the blood supply of tumor in one group and the iodized oil perfused according to the actual tumor diameter in the other. The filling of lipiodol in HCC was observed and conformation rate was compared in the two groups. When the diameter of HCC was less than 10 cm, 10 - 20 ml and 5 - 10 ml lipiodol was injected in to the sufficient blood supply and the poor supply groups. When the diameter of HCC was more than 10 cm, 20 - 30 ml iodized oil was injected in the sufficient blood supply group. The lipiodol dose in the mixed blood supply group was determined by the diameter of sufficient blood supply area.

RESULTSThe conformation and effective rate were 82%, 84% in the first group and 36%, 46% in the second group (P < 0.01).

CONCLUSIONA relative individualized lipiodol dose may be determined according to the blood supply pattern and the tumor diameter by CT imaging.