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J Vasc Interv Radiol. 2017 Mar;28(3):334-341. doi: 10.1016/j.jvir.2016.11.037. Epub 2017 Jan 18.

The Role of Cone-Beam CT in Transcatheter Arterial Chemoembolization for Hepatocellular Carcinoma: A Systematic Review and Meta-analysis.

Author information

1
Siemens Medical Solutions USA, Inc, Malvern, Pennsylvania.
2
Division of Interventional Radiology, Stanford University School of Medicine, 300 Pasteur Drive, H3630, Stanford, CA94305-5642.
3
Lane Medical Library, Stanford University, Stanford, California.
4
Division of Interventional Radiology, Stanford University School of Medicine, 300 Pasteur Drive, H3630, Stanford, CA94305-5642; Stanford Health Care, Stanford, California.
5
Division of Interventional Radiology, Stanford University School of Medicine, 300 Pasteur Drive, H3630, Stanford, CA94305-5642; Stanford Health Care, Stanford, California. Electronic address: kothary@stanford.edu.

Abstract

PURPOSE:

To review available evidence for use of cone-beam CT during transcatheter arterial chemoembolization in hepatocellular carcinoma (HCC) for detection of tumor and feeding arteries.

MATERIALS AND METHODS:

Literature searches were conducted from inception to May 15, 2016, in PubMed (MEDLINE), Scopus, and Cochrane Central Register of Controlled Trials. Searches included "cone beam," "CBCT," "C-arm," "CACT," "cone-beam CT," "volumetric CT," "volume computed tomography," "volume CT," AND "liver," "hepatic*," "hepatoc*." Studies that involved adults with HCC specifically and treated with transcatheter arterial chemoembolization that used cone-beam CT were included.

RESULTS:

Inclusion criteria were met by 18 studies. Pooled sensitivity of cone-beam CT for detecting tumor was 90% (95% confidence interval [CI], 82%-95%), whereas pooled sensitivity of digital subtraction angiography (DSA) for tumor detection was 67% (95% CI, 51%-80%). Pooled sensitivity of cone-beam CT for detecting tumor feeding arteries was 93% (95% CI, 91%-95%), whereas pooled sensitivity of DSA was 55% (95% CI, 36%-74%).

CONCLUSIONS:

Cone-beam CT can significantly increase detection of tumors and tumor feeding arteries during transcatheter arterial chemoembolization. Cone-beam CT should be considered as an adjunct tool to DSA during transcatheter arterial chemoembolization treatments of HCC.

PMID:
28109724
DOI:
10.1016/j.jvir.2016.11.037
[Indexed for MEDLINE]

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