Evaluation of cone-beam CT hepatic angiography in detecting the tumor-feeding arteries during the performance of TACE for HCC
10.3969/j.issn.1008-794X.2015.06.005
- VernacularTitle:锥体束CT三维肝动脉造影在TACE术中判断原发性肝癌肿瘤供血动脉的临床价值
- Author:
Jungang HU
;
Xiaodong WANG
;
Xu ZHU
;
Guang CAO
;
Hui CHEN
;
Renjie YANG
- Publication Type:Journal Article
- Keywords:
cone-beam CT hepatic arteriography;
digital subtraction hepatic arteriography;
hepatoc ellular carcinoma;
hepatic arterial chemoembolization
- From:
Journal of Interventional Radiology
2015;(6):481-487
- CountryChina
- Language:Chinese
-
Abstract:
Objective To accurately judge the tumor-feeding artery is the most important basis for a successful treatment of hepatocellular carcinoma (HCC) with super-selective hepatic arterial chemoembo lization therapy. This study aims to assess the clinical value of cone-beam CT hepatic arteriography (CBCT-HA) in detecting tumor-feeding arteries during the performance of conventional transarterial chemoembo lization (TACE), and to compare the diagnostic effects between CBCT-HA and non-selective hepatic DSA. Methods Twenty-three consecutive patients with inoperable HCC were enrolled in this study. TACE was carried out in all patients. During the performance of TACE, the DSA-HA, CBCT-HA, Lipiodol-TACE and Lipiodol-CBCT were performed separately. The imaging materials, including DSA-HA and CBCT-HA, were analyzed by two experienced interventional physicians together to judge the tumor-feeding arteries. Statistic analysis was conducted by using chi square test. Results Tumor stain and lipiodol accumulation were regarded as the “gold standard” of the presence of tumor-feeding artery, based on which the tumor-feeding artery was confirmed in 75 lesions. DSA-HA demonstrated positive tumor-feeding artery in 40 lesions, among which true-positive tumor-feeding artery was seen in 32 and false-positive one in 8. CBCT-HA showed positive tumor-feeding artery in 72 lesions, which included true-positive tumor-feeding artery in 68 and false-positive one in 4. The sensitivity of CBCT-HA in judging tumor-feeding artery was 90.7% (68/75), which was much higher than that of DSA-HA (42.6%, 32/75), the difference was statistically significant(P<0.001). The positive predictive value of CBCT-HA in detecting tumor-feeding artery was also higher than that of DSA-HA (94.4% vs. 80.0%; P=0.040). Conclusion Cone-beam CT hepatic arteriography is obviously superior to DSA hepatic arteriography in identifying tumor-feeding arteries, which is very helpful in guiding super-selective TACE for HCC.
