| Affiliation: | 1. Siemens Medical Solutions USA, Inc, Malvern, Pennsylvania;2. Division of Interventional Radiology, Stanford University School of Medicine, 300 Pasteur Drive, H3630, Stanford, CA94305-5642;3. Lane Medical Library, Stanford University, Stanford, California;4. Stanford Health Care, Stanford, California |
| Abstract: | PurposeTo review available evidence for use of cone-beam CT during transcatheter arterial chemoembolization in hepatocellular carcinoma (HCC) for detection of tumor and feeding arteries.Materials and MethodsLiterature searches were conducted from inception to May 15, 2016, in PubMed (MEDLINE), Scopus, and Cochrane Central Register of Controlled Trials. Searches included “cone beam,” “CBCT,” “C-arm,” “CACT,” “cone-beam CT,” “volumetric CT,” “volume computed tomography,” “volume CT,” AND “liver,” “hepatic*,” “hepatoc*.” Studies that involved adults with HCC specifically and treated with transcatheter arterial chemoembolization that used cone-beam CT were included.ResultsInclusion criteria were met by 18 studies. Pooled sensitivity of cone-beam CT for detecting tumor was 90% (95% confidence interval [CI], 82%–95%), whereas pooled sensitivity of digital subtraction angiography (DSA) for tumor detection was 67% (95% CI, 51%–80%). Pooled sensitivity of cone-beam CT for detecting tumor feeding arteries was 93% (95% CI, 91%–95%), whereas pooled sensitivity of DSA was 55% (95% CI, 36%–74%).ConclusionsCone-beam CT can significantly increase detection of tumors and tumor feeding arteries during transcatheter arterial chemoembolization. Cone-beam CT should be considered as an adjunct tool to DSA during transcatheter arterial chemoembolization treatments of HCC. |
