Clinical StudyThe Efficacy of Cone-Beam CT–Based Liver Perfusion Mapping to Predict Initial Response of Hepatocellular Carcinoma to Transarterial Chemoembolization
Section snippets
Study Design and Patient Population
This retrospective, single-center study was approved by the institutional review board with a waiver for informed consent for the observational period from July 2015 to June 2016. During this observational period, consecutive patients with a confirmed diagnosis of HCC according to dynamic CT or MR imaging (image diagnosis of HCC was based on arterial enhancement and washout in the portal venous or delayed phase) who underwent conventional transarterial chemoembolization using a cone-beam CT
Follow-up Data after Transarterial Chemoembolization
There were 57 tumors observed in 35 patients with a median tumor size of 2.9 cm (range, 0.6–11.3 cm). Technical success was evaluated on angiography, unenhanced cone-beam CT, contrast-enhanced cone-beam CT, and cone-beam CT–based liver perfusion mapping, and tumor response were evaluated by follow-up dynamic liver CT (n = 15), dynamic liver MR imaging (n = 18), and histologic examination (n = 2). The last 2 patients underwent liver transplantation after transarterial chemoembolization, and
Discussion
In this study, cone-beam CT–based liver perfusion mapping showed the highest confidence level for visual assessment of viable tumors after transarterial chemoembolization among reviewers. The diagnostic performance for detection of viable tumor on angiography after transarterial chemoembolization was far inferior. The inherent lower detection rate of HCC and the masking by ethiodized oil staining may make it more difficult to detect viable tumor on angiography during or after transarterial
Acknowledgments
This study has received funding from the Basic Science Research Program through the National Research Foundation of Korea, funded by the Ministry of Education (NRF-2016R1D1A1B04935077).
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None of the authors have identified a conflict of interest.
From the SIR 2018 Annual Scientific Meeting.