Role of C-Arm CT in Identifying Caudate Arteries Supplying Hepatocellular Carcinoma |
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| Affiliation: | 1. Department of Radiology, Seoul National University College of Medicine, Seoul, Korea;2. Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul, Korea;3. Clinical Research Institute, Seoul National University Hospital, Seoul, Korea;4. Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Korea;1. Vascular Surgery, Department of Surgery and Morphological Sciences, Circolo University Hospital, University of Insubria School of Medicine, Varese, Italy;2. Interventional Radiology, Department of Surgery and Morphological Sciences, Circolo University Hospital, University of Insubria School of Medicine, Varese, Italy;3. Cardiac Surgery, University of Leicester, Glenfield Hospital, Leicester, UK;4. Thoracic Aortic Research Center, IRCCS Policlinico San Donato, San Donato Milanese, Italy;1. Department of Vascular Surgery, Military Hospital Val-de-Grâce, Paris, France;2. Department of Oncology, Military Hospital Val-de-Grâce, Paris, France;3. Department of Cardiac Pathology, Institut Mutualiste Montsouris, Paris, France;1. Department of Radiology and Section of Angiography and Endovascular Therapy, Hospital Italiano de Buenos Aires, C/Pte. J.D. Perón 4190, Buenos Aires 1414, Argentina;2. Department of Internal Medicine, Hospital Italiano de Buenos Aires, C/Pte. J.D. Perón 4190, Buenos Aires 1414, Argentina;3. Section of Computed Tomography, Hospital Italiano de Buenos Aires, C/Pte. J.D. Perón 4190, Buenos Aires 1414, Argentina |
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| Abstract: | PurposeTo evaluate the role of C-arm computed tomography (CT) performed at the proper hepatic artery or equivalent in patients with caudate-lobe hepatocellular carcinoma (HCC) for the detection of tumor-feeding arteries during chemoembolization.Materials and MethodsFrom July 2009 to June 2012, 1,785 patients received initial chemoembolization at a single institution. Among them, 52 patients with caudate HCC underwent initial chemoembolization with the use of C-arm CT. C-arm CT images were obtained at the proper hepatic artery or equivalent. Two radiologists reviewed the C-arm CT scans and angiograms in consensus. The cumulative local recurrence rate was calculated by the Kaplan–Meier method.ResultsTumor-feeding arteries were single (n = 31), double (n = 12), triple (n = 6), and quadruple (n = 3). Seventy-nine tumor-feeding arteries and their origins in 48 patients were demonstrated on C-arm CT. In four patients (7.7%), five tumor-feeding arteries were not clearly indicated on C-arm CT because of poor image quality caused by failure of the patients to hold their breath. Selective chemoembolization via tumor-feeding arteries was successful in 45 patients (87%). The cumulative local recurrence rates at 6 months, 1 year, and 3 years were 19.4%, 32.8%, and 35.8%, respectively. Nonselective chemoembolization of tumor-feeding arteries of caudate-lobe HCC was a significantly important factor in higher cumulative local recurrence rates (hazard ratio, 3.916; 95% confidence interval, 1.367–11.216; P = .011).ConclusionC-arm CT obtained at the proper hepatic artery or equivalent level can demonstrate most tumor-feeding arteries supplying HCCs in the caudate lobe. |
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