Comparative study on digital substraction angiography and CT diagnosis for the residual and new lesions of primary hepatocelluar carcinoma after transcatheter arterial chemoembolization

Abstract

Objective To comparative analyze the CT enhanced scan and digital substraction angiography (DSA) in showing the residual and new lesions after treatment of transcatheter arterial chemoembolization (TACE).Methods 60 cases of patients with complete clinical information and imaging data from June 2010 to February 2013 were collected,these patients were diagnosed of primary hepatocelluar carcinoma and underwent TACE treatment.The sensitivity and specificity of CT and DSA to detect the residual and new lesions after TACE treatment were analyzed.By analysis of the main factors affecting the low detection rate to seek a method that can improve PHC residual new lesions detection rate after TACE.Results There were 86 lesions in 60 cases,CT enhanced scan clearly determined the diagnosis of 49 lesions (42 residues,7 new lesions).37 lesions did not prompted to tumor recurrence (residual and new lesions).DSA as the gold standard,the sensitivity of CT enhanced scan to check out the lesions was 84.5 ％ (49/58),specificity was 100.0 ％ (28/28),the false negative rate was 15.5 ％ (9/58),the accuracy was 89.5 ％ (77/86).Enhanced CT detection rate of tumor recurrence was 57.0 ％ (49/86),the DSA detection rate of tumor recurrence was 67.4 ％ (58/86).The difference of determining tumor recurrence between the CT enhanced scan and DSA was significant (x2 =7.11,P ＜ 0.05).Conclusions Three dynamic contrast-enhanced CT scan is the first choice for follow-up examination methods after TACE for hepatocellular carcinoma,but many factors will affect the detection rate of the residual and new lesions.Compared with CT examination,DSA examination has more advantages.DSA examination should be performed when the clinical suspicion of tumor recurrence is negative after enhanced CT scan. Key words: Liver neoplasms; Chemoembolization, therapeutic; Tomography, computed; Angiography, digital subtraction