Efficacy and safety of transarterial chemoembolisation with cone-beam CT in patients with hepatocellular carcinoma within the Milan criteria: a retrospective cohort study

Lee, J.H.; Lee, I.J.; Kim, H.B.; Park, Bumsu; Kim, B.H.; Park, J.-W.; Kim, C.-M.

doi:10.1016/j.crad.2019.01.024

Cited by 5 publications

(4 citation statements)

References 24 publications

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“…The usefulness of CTHA, including cone-beam CTHA during the TACE procedure, has been reported because of its ability to offer relevant information for tumor identification, assessment of tumor feeding artery, and navigation guidance. 22 , 23 , 24 Moreover, it has become possible for the accurate identification of tumor feeding arteries in combination with guidance software 19 , suggesting that CTHA will be performed more frequently during TACE. By performing not only the early phase of CTHA but also the late phase of CTHA and depicting the corona-like deep stain, CTHA can be used not only for tumor vessel identification and navigation guidance but also for determination of safety margin.…”

Section: Discussionmentioning

confidence: 99%

Comparison of local recurrence in transcatheter arterial chemoembolization of hepatocellular carcinoma with or without accumulation of iodized oil beyond corona enhancement area: Short-term results

Watanabe

Ogawa

Kaneko

et al. 2021

Radiology and Oncology

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Background Local tumor recurrence of hepatocellular carcinoma (HCC) often occurs in blood drainage areas. Corona enhancement is determined by computed tomography during hepatic arteriography (CTHA) and is considered to represent the blood drainage area. This study aimed to investigate the relationship between embolization of corona enhancement area and local tumor recurrence of patients with HCC who underwent transcatheter arterial chemoembolization (TACE). Patients and methods The study retrospectively selected 53 patients with 60 HCC nodules that showed corona enhancement area on late-phase CTHA and showed homogenous accumulation of iodized oil throughout the nodule on non-contrast-enhanced CT performed immediately after TACE. We divided the nodules into two groups, according to whether the accumulation of iodized oil covered the entire corona enhancement area (group A) or not (group B). Local tumor recurrence was compared between the two groups. Results The cumulative local tumor recurrence rates for group A (n = 36) were 2.8%, 2.8%, 8.3% at 3, 6, and 12 months, respectively, whereas the recurrence rates for group B (n = 24) were 20.8%, 45.8%, 75% at 3, 6, and 12 months, respectively. The cumulative local tumor recurrence rates for group A were significantly lower than those for group B (hazard ratio, 0.079; 95% confidence interval, 0.026–0.24; p < 0.001). Conclusions The results of the study suggest that the corona enhancement area may be an accurate safety margin in TACE which should be performed until the embolic area covers the entire corona enhancement area.

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Section: Discussionmentioning

confidence: 99%

Comparison of local recurrence in transcatheter arterial chemoembolization of hepatocellular carcinoma with or without accumulation of iodized oil beyond corona enhancement area: Short-term results

Watanabe

Ogawa

Kaneko

et al. 2021

Radiology and Oncology

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“…For the SACE emulsion, the protocol reported in previous reports 12,14,21,22 was modified to enhance its cytotoxic effect. In brief, 50 mg of doxorubicin hydrochloride (Adriamycin, Ildong Pharmaceutical, Seoul, Republic of Korea) in a 2.5 mL of contrast agent (Xenetix 350; Iobitridol, Guerbet, Aulnay-sous-Bois, France) was emulsified with 10 mL of ethiodized oil (Lipiodol; Guerbet, Aulnay-sous-Bois, France) 23 . Ethanol (dehydrated alcohol 99.5%, Taiwan BIOTECH, Taiwan) was mixed with the emulsion at a volume ratio of 1:2 12,14,21,22 .…”

Section: Patientsmentioning

confidence: 99%

“…Ethanol (dehydrated alcohol 99.5%, Taiwan BIOTECH, Taiwan) was mixed with the emulsion at a volume ratio of 1:2 12,14,21,22 . After confirming the tumor feeders by rotational cone-beam CT https://doi.org/10.17998/jlc.2024.05.08 hepatic arteriography as previously reported 23,24 , SACE was performed as selectively as possible through the tumor-feeding arteries using a microcatheter with a 1.5-F tip (Velute Ultra; Asahi, Tokyo, Japan) 23,25,26 . Completion of SACE was determined when tumor arterial staining disappeared and the tumor-feeding arteries were completely embolized 23 .…”

Section: Patientsmentioning

confidence: 99%

Superselective ablative chemo-ethanol embolization for recurrent single hepatocellular carcinoma: a 6-month outcome analysis

Lee,

Kim,

Lee

et al. 2024

JLC

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Background/Aim: To evaluate the safety and effectiveness of superselective ablative chemoethanol embolization (SACE) for the treatment of patients with recurrent single hepatocellular carcinoma (rHCC).Materials and Methods: This retrospective study included 22 patients (19 men, median age 63 [range 38-86 y]) with Child-Pugh class of A/B/C (16/3/3) that underwent SACE between January and June 2023 for recurrent single HCCs measuring ≤ 5 cm in diameter using a mixture of 99% Ethanol and ethiodized oil/doxorubicin emulsion. The primary endpoint was the 6month tumor response, and the secondary endpoints were the 1-month tumor response and treatment-related safety. This study was approved by our institutional review board, and the requirement for informed consent was waived.Results: SACE was successfully performed in 22 (95.2%) patients. The complete response rates at 1-month and 6-month after treatment were 100% and 83.3%, respectively. At 6-month, local tumor progression occurred in one patient and intrahepatic distant metastasis was found in 6 (30%) patients. No 6-month mortalities were reported. No adverse events greater than grade 2 or laboratory deteriorations were observed. Biliary complications or liver abscesses were not observed.Conclusion: SACE for a single rHCC was highly effective in achieving a favorable 6-month tumor response and showed acceptable adverse events. However, further prospective studies are required to verify these findings.

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“…During TACE treatment, cone-beam computed tomography (CBCT) can be useful in identifying liver lesions and their arterial feeders, improving the technical success of the treatment compared to TACE performed using DSA alone [ 7 , 8 , 9 ].…”

Section: Introductionmentioning

confidence: 99%

The Role of Immediate Post-Procedural Cone-Beam Computed Tomography (CBCT) in Predicting the Early Radiologic Response of Hepatocellular Carcinoma (HCC) Nodules to Drug-Eluting Bead Transarterial Chemoembolization (DEB-TACE)

Fronda

Mistretta²,

Calandri³

et al. 2022

JCM

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The purpose of this study was to evaluate the efficacy of unenhanced cone-beam computed tomography (CBCT) performed at the end of drug-eluting bead transarterial chemoembolization (DEB-TACE) in predicting HCC nodules’ early radiologic response to treatment, assessed using mRECIST criteria with a 30–60 day four-phase contrast-enhanced CT follow-up. Fifty-nine patients (81 lesions) subjected to DEB-TACE as exclusive treatment for HCC lesions (naive/relapse) between February 2020 and October 2021 were prospectively enrolled. In a post-interventional unenhanced CBCT procedure, two experienced radiologists evaluated for each lesion the overall intensity of the contrast media deposit, the homogeneity of the enhancement, and the presence of smooth and complete margins. The univariate analysis found that lesions with complete response (CR+) had a significantly higher incidence of clear and complete margins than CR- lesions (76.9% vs. 17.2%, p = 0.003) and a higher intensity score (67.3% vs. 27.6%, p = 0.0009). A Dmax <30 mm was significantly more common among CR+ than CR- lesions (92.3% vs. 69%, p = 0.01). These features were confirmed as significant predictors for CR+ by multivariate binary logistic regression. The homogeneity of the enhancement did not affect the DEB-TACE outcome. Post-interventional unenhanced CBCT is effective in predicting early radiological response to DEB-TACE, since the presence of an intense contrast media deposit with clear and complete margins in treated HCC lesions is associated with CR.

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Efficacy and safety of transarterial chemoembolisation with cone-beam CT in patients with hepatocellular carcinoma within the Milan criteria: a retrospective cohort study

Cited by 5 publications

References 24 publications

Comparison of local recurrence in transcatheter arterial chemoembolization of hepatocellular carcinoma with or without accumulation of iodized oil beyond corona enhancement area: Short-term results

Comparison of local recurrence in transcatheter arterial chemoembolization of hepatocellular carcinoma with or without accumulation of iodized oil beyond corona enhancement area: Short-term results

Superselective ablative chemo-ethanol embolization for recurrent single hepatocellular carcinoma: a 6-month outcome analysis

The Role of Immediate Post-Procedural Cone-Beam Computed Tomography (CBCT) in Predicting the Early Radiologic Response of Hepatocellular Carcinoma (HCC) Nodules to Drug-Eluting Bead Transarterial Chemoembolization (DEB-TACE)

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