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J Vasc Interv Radiol. 2010 Mar;21(3):339-47. doi: 10.1016/j.jvir.2009.11.007. Epub 2010 Feb 4.

Utility of C-arm CT in patients with hepatocellular carcinoma undergoing transhepatic arterial chemoembolization.

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1
Division of Interventional Radiology, Stanford University Medical Center, 300 Pasteur Dr, H3652, Stanford, CA 94305-5642, USA.

Abstract

PURPOSE:

To evaluate the utility of C-arm computed tomography (CT) on treatment algorithms in patients undergoing transhepatic arterial chemoembolization for hepatocellular carcinoma (HCC).

MATERIALS AND METHODS:

From March 2008 to July 2008, 84 consecutive patients with HCC underwent 100 consecutive transhepatic arterial chemoembolizations with iodized oil. Unenhanced and iodinated contrast medium-enhanced C-arm CT with planar and three-dimensional imaging were performed in addition to conventional digital subtraction angiography (DSA) in all patients. The effect on diagnosis and treatment was determined by testing the hypotheses that C-arm CT, in comparison to DSA, provides (a) improved lesion detection, (b) expedient identification and mapping of arterial supply to a tumor, (c) improved characterization of a lesion to allow confident differentiation of HCC from pseudolesions such as arterioportal shunts, and (d) an improved evaluation of treatment completeness. The effect of C-arm CT was analyzed on the basis of information provided with C-arm CT that was not provided or readily apparent at DSA.

RESULTS:

C-arm CT was technically successful in 93 of the 100 procedures (93%). C-arm CT provided information not apparent or discernible at DSA in 30 of the 84 patients (36%) and resulted in a change in diagnosis, treatment planning, or treatment delivery in 24 (28%). The additional information included, amongst others, visualization of additional or angiographically occult tumors in 13 of the 84 patients (15%) and identification of incomplete treatment in six (7.1%).

CONCLUSIONS:

C-arm CT is a useful collaborative tool in patients undergoing transhepatic arterial chemoembolization and can affect patient care in more than one-fourth of patients.

Comment in

PMID:
20133156
DOI:
10.1016/j.jvir.2009.11.007
[Indexed for MEDLINE]
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