Abstract
Background Liver dynamic computed tomography (CT) is an established method for pre- and post-interventional evaluation of hepatocellular carcinoma. To date only the liver parenchyma and perfusion information of dynamic CT has been evaluated widely. Purpose To evaluate the vascular information contained in dynamic CT datasets. Material and Methods Dynamic CT performed one day after transarterial chemoembolization (60 mL of contrast medium, 6 mL/s, 40 s scan duration) were retrospectively evaluated. Conventional slice and angiographic maximum-intensity-projection reconstructions were calculated on a multi-modality post-processing platform. Datasets were evaluated for viable tumor, anatomy of the vasculature, and potential tumor-feeding vessels. The results were compared to digital subtraction angiography images. Results In total, 94 treated hepatocellular carcinoma nodules were evaluated (62 dynamic CT scans, 46 patients [34 men; mean age = 69 years]). Forty-six partially viable tumors were diagnosed after transarterial chemoembolization. In all of these, tumor-feeding vessels were found in dynamic CT. Seventeen suspected extra-hepatic tumor feeders were reported, of which 14 had not been found during previous transarterial chemoembolization. Conclusion Dynamic CT is useful in post-interventional imaging of hepatocellular carcinoma after transarterial chemoembolization due to its ability to detect residual viable tumor parts and to show previously unknown intra- and extra-hepatic tumor-feeding vessels.
Highlights
Hepatocellular carcinoma (HCC) is the sixth most common cancer and the third most common cause of death from cancer worldwide [1]
In 22 of 34 dynamic CT (dCT) with residual viable tumors, the dCT showed viable tumors which were not suspected in the corresponding Digital subtraction angiography (DSA) images
The aim of this study was to evaluate the usefulness of dCT for liver imaging after Transarterial chemoembolization (TACE) in patients with
Summary
Hepatocellular carcinoma (HCC) is the sixth most common cancer and the third most common cause of death from cancer worldwide [1]. Liver dynamic CT (dCT) can be used for postinterventional imaging after TACE In this scan mode, multiple repetitive scans of the liver are performed while a contrast bolus flows through the vessels and liver parenchyma [5,6]. Multiple repetitive scans of the liver are performed while a contrast bolus flows through the vessels and liver parenchyma [5,6] This four-dimensional (4D) dataset can be reconstructed in different ways: conventional slice reconstructions demonstrate possible contrast-enhancing tumor remnants. Liver dynamic computed tomography (CT) is an established method for pre- and post-interventional evaluation of hepatocellular carcinoma. Conclusion: Dynamic CT is useful in post-interventional imaging of hepatocellular carcinoma after transarterial chemoembolization due to its ability to detect residual viable tumor parts and to show previously unknown intra- and extrahepatic tumor-feeding vessels
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