Detection of hepatocellular carcinoma by CT during arterial portography using a cone-beam CT technology: comparison with conventional CTAP

Miyayama, Shiro; Matsui, Osamu; Yamashiro, Masashi; Ryu, Yasuji; Takata, Harumi; Takeda, Taro; Aburano, Hiroyuki; Shigenari, Noriaki

doi:10.1007/s00261-007-9254-9

Cited by 47 publications

(41 citation statements)

References 7 publications

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“…9 In addition, all small HCCs (mean diameter 1.3 ± 0.3 cm) that could not be detected on arteriography could be depicted by combined with CBCTAP, CBCTHA, and LipCBCT (Figs. 1-11).…”

Section: Cbct Techniquementioning

confidence: 98%

“…[2][3][4][5] CBCTA through extrahepatic collateral vessels is useful for avoiding nontarget embolization (Figs. 8,9). When CBCTA shows enhancement of the nontumor tissues as well as tumor staining, the catheter should be distally advanced into the tumor-feeding branch to prevent unnecessary embolization of vessels that do not supply the tumor (Fig.…”

Section: Confi Rmation Of Embolized Areamentioning

confidence: 99%

“…1, 3, 12). 9 An advanced algorithm and a faster scanning protocol to reduce these image artifacts may be needed to improve the image quality. The FOV of CBCT is also too small to observe the entire liver.…”

Section: Recognition Of Endpoints Of Tacementioning

confidence: 99%

“…This technique is currently being combined with TACE for HCC. [7][8][9][10][11][12] In this article, we describe the effi cacy of CBCT during TACE for HCC.…”

Section: Introductionmentioning

confidence: 99%

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Efficacy of cone-beam computed tomography during transcatheter arterial chemoembolization for hepatocellular carcinoma

et al. 2011

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Cone-beam computed tomography (CBCT) using a flat-panel detector is an alternative method of obtaining cross-sectional images. This technique is now being used during transcatheter arterial chemoembolization (TACE) for inoperable hepatocellular carcinoma (HCC). Several CBCT techniques are performed to detect HCC lesions: CBCT during portography (CBCTAP), CBCT during hepatic arteriography (CBCTHA), CBCT after iodized oil injection (LipCBCT), CBCT during arteriography (CBCTA) of extrahepatic collaterals. Almost all HCC lesions can be detected using these CBCT images. Three-dimensional arteriography using maximum intensity projection from CBCTHA images can identify the tumor-feeding branch. In particular, this technique is useful when the tumor stain cannot be demonstrated on arteriography. In addition, dual-phase CBCTHA can improve the diagnostic accuracy for hypervascular HCCs because corona enhancement can be detected around the tumor. To monitor the embolized area during TACE, selective CBCTHA or LipCBCT at the embolization point is useful. Two sequential CBCT scans without and with contrast material injection is also useful to confirm each embolized area of two vessels. Furthermore, CBCTA can prevent nontarget embolization. Although the image quality of CBCT is low compared to that of conventional CT, CBCT provides useful information that helps perform TACE for HCCs safely and effectively.

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“…9 In addition, all small HCCs (mean diameter 1.3 ± 0.3 cm) that could not be detected on arteriography could be depicted by combined with CBCTAP, CBCTHA, and LipCBCT (Figs. 1-11).…”

Section: Cbct Techniquementioning

confidence: 98%

Section: Confi Rmation Of Embolized Areamentioning

confidence: 99%

Section: Recognition Of Endpoints Of Tacementioning

confidence: 99%

“…This technique is currently being combined with TACE for HCC. [7][8][9][10][11][12] In this article, we describe the effi cacy of CBCT during TACE for HCC.…”

Section: Introductionmentioning

confidence: 99%

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Efficacy of cone-beam computed tomography during transcatheter arterial chemoembolization for hepatocellular carcinoma

et al. 2011

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“…For example, CBCT is equally as sensitive as multiphasic MRI in detecting tumors. [7][8][9][10] A recent improvement of the CBCT is DualPhase CBCT (DPCBCT). DPCBCT (Philips Healthcare, Best, The Netherlands) can acquire multi-phasic scans using only one injection of contrast media.…”

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confidence: 99%

Can C-Arm Cone-Beam CT Detect a Micro-Embolic Effect After TheraSphere Radioembolization of Neuroendocrine and Carcinoid Liver Metastasis?

Pellerin

Lin²,

Bhagat

et al. 2013

Cancer Biotherapy and Radiopharmaceuticals

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Rational and Objective: Radioembolization with yttrium-90 microspheres is a therapy that is used for hepatic tumors. 20-30 lm microspheres loaded with Y90 are supposedly occluding tumor vessels at the capillary level. Then, these spheres deliver high-dose radiation to the tumor. However, this theoretical embolic effect has never been appreciated in imaging. Dual-Phase cone-beam computed tomography (DPCBCT) is a multi-phasic intraprocedural scan that uses only one contrast media injection to visualize early (feeding vessel) and delayed (capillary level) tumor enhancement. The purpose of this study was to determine whether there is a microembolic effect induced by TheraSpheresÒ (MDS Nordion, Ottawa, Ontario, Canada) at the capillary level by using DPCBCT imaging. Materials and Methods: 14 patients with 72 carcinoid or neuroendocrine tumors were treated with radioembolization, and all underwent DPCBCT (Allura Xper, Philips Healthcare) imaging before and immediately after radioembolization with TheraSpheresÒ. Tumor enhancement was measured in each phase by drawing a region of interest within the tumors. Results: 72 tumors were evaluated: average tumor density in the early arterial phase was 241 and 230 Hounsfield units (HU) ( p < 0.001) before and after radioembolization, respectively; the average density in the delayed arterial phase was 226 and 161 HU ( p < 0.001) before and after radioembolization, respectively. Average difference in tumor attenuation before and after radioembolization in early arterial and delayed phase was 11 HU and 64 HU ( p < 0.001), respectively. Conclusion: The significant decrease in tumor enhancement in the DPCBCT delayed phase after TheraSpheresÒ injection indicates that there is an appreciable microembolic effect at the tumor capillary bed level.

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CBCT and Software

De Rubeis,

Castiello,

Giuliani

et al. 2023

Transarterial Chemoembolization (TACE)

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Detection of hepatocellular carcinoma by CT during arterial portography using a cone-beam CT technology: comparison with conventional CTAP

Abstract: CBCTAP had sufficient image quality to detect almost all small HCC lesions compared to conventional CTAP and could depict approximately 89% of HCC nodules, including eight suboptimal lesions.

Cited by 47 publications

References 7 publications

Efficacy of cone-beam computed tomography during transcatheter arterial chemoembolization for hepatocellular carcinoma

Efficacy of cone-beam computed tomography during transcatheter arterial chemoembolization for hepatocellular carcinoma

Can C-Arm Cone-Beam CT Detect a Micro-Embolic Effect After TheraSphere Radioembolization of Neuroendocrine and Carcinoid Liver Metastasis?

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