Abstract No. 540 Usefulness of Dyna computed tomography in hepatocellular carcinoma: transarterial chemoembolization for segment 1 of the liver

Abstract

To evaluate usefulness of the Dyna-CT in hepatocellular carcinoma treated by transarterial chemoembolization (TACE) for segment 1 (S1) of the liver. Total 24 session of TACE was performed in 20 patients (mean age, 63.0; range, 48-86 years) to treat HCC in S1 from March 2017 to July 2019. Multiplanar reconstruction (MPR) images and embolization guidance program by 3-dimensional reconstruction of the Dyna-CT were used for diagnosis of HCC and superselection of the feeding artery with microcatheter set. TACE procedures were done by conventional method with doxorubicin, ethiodized oil, and gelatin sponge. Digital subtraction angiogram (DSA) and Dyna-CT Images obtained during TACE including medical records were reviewed to evaluate detection of the HCC, tumor size, characteristics of the feeding artery, superselected artery, and radiation dose for Dyna-CT. Follow-up liver dynamic CT images were also reviewed to evaluate success of treatment. HCCs were visualized 14 cases (58.3%) on DSA and all cases on MPR images of the Dyna-CT. Mean size of HCCs was 16.1 mm(range, 5-94 mm) on Dyna-CT. Numbers of the feeding artery were one in 22 cases (91.7%) and two in 2 cases (8.3%). Among of 26 feeding arteries, they were originated from territory of the right hepatic artery (RHA) in 14 and left hepatic artery (LHA) in 12. Most common origin of the segment 1 hepatic artery (S1HA) was RHA (n = 11, 42.3%). Superselective TACE of the S1HA was successful in 15 arteries (57.7%) and TACE was done at proximal artery to origin of the S1HA in 11 arteries (42.3%). Dense uptake of ethiodized oil was detected in all cases after superselective TACE of the S1HA and in 2 cases (18.1%) after proximal TACE. Mean cumulative dose of radiation by Dyna-CT was 201.9 mGy. Dyna-CT was useful to detect the HCC in S1 compared with DSA. Embolization guidance seems to be helpful for superselective TACE and uptake of the ethiodized oil in the HCC.