Correlation between Tumor Perfusion and Lipiodol Deposition in Hepatocellular Carcinoma after Transarterial Chemoembolization

Abstract

To study the correlation of tumor perfusion with lipiodol deposition in hepatocellular carcinoma (HCC) after transarterial chemoembolization with multidetector computed tomography (MDCT) perfusion imaging. MDCT perfusion imaging was performed in 24 patients with HCC 1 to 7 days before chemoembolization. The computed tomography (CT) perfusion parameters, such as hepatic arterial perfusion (HAP), hepatic portal perfusion (HPP), total liver perfusion (TLP), and hepatic arterial perfusion index (HAPI), were calculated with the slope method. The follow-up CT scans (noncontrast) were performed 4 weeks after chemoembolization to analyze lipiodol deposition. The lipiodol deposition in the tumor was classified into three grades and compared with CT perfusion parameters before chemoembolization. The HAP and TLP of tumors before chemoembolization were correlated with the grades of lipiodol deposition in tumors after chemoembolization (r = 0.768, P < .0001 and r = 0.616, P = .001, respectively). However, the HPP and HAPI of the tumors were not related to the grades of iodized oil deposition (r = 0.227, P = .286 and r = 0.111, P = .607, respectively). Higher HAP was correlated with better lipiodol deposition, and lower HAP was correlated with poorer lipiodol deposition. MDCT perfusion imaging has the potential to help select more appropriate patients with HCC for chemoembolization.