Radiologic Monitoring of Hepatocellular Carcinoma Tumor Viability after Transhepatic Arterial Chemoembolization: Estimating the Accuracy of Contrast-enhanced Cross-sectional Imaging with Histopathologic Correlation

Hunt, Stephen; Yu, Woojin M.; Weintraub, Joshua; Prince, Martin R.; Kothary, Nishita

doi:10.1016/j.jvir.2008.09.034

Cited by 63 publications

(36 citation statements)

References 45 publications

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“…The potential benefit of diffusion-weighted MRI consists in more precise delineating the extent of the tumor necrosis at baseline, making later therapeutic decisions more appropriate [14] . In addition, modern crosssectional imaging will also provide detailed information on tumor extent, portal vein invasion or thrombosis and variant arterial anatomy of the celiac trunk and end branches.…”

Section: Preinterventional Workupmentioning

confidence: 99%

Transcatheter Chemoembolization of Unresectable Hepatocellular Carcinoma: Current Knowledge and Future Directions

Maleux¹,

Malenstein

Vandecaveye³

et al. 2009

Dig Dis

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Transarterial chemoembolization (TACE) is considered the gold standard for the treatment of unresectable hepatocellular carcinoma (HCC) in patients with a preserved liver function and in the absence of clear extrahepatic tumor spread. This review article deals with the radiological and clinical workup, the interventional technique of chemoembolization for HCC and gives an overview of the common as well as some rare and dramatic complications of TACE. Finally, some new trends and advances in clinical research with regard to the interventional management of HCC are discussed.

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Section: Preinterventional Workupmentioning

confidence: 99%

Transcatheter Chemoembolization of Unresectable Hepatocellular Carcinoma: Current Knowledge and Future Directions

Maleux¹,

Malenstein

Vandecaveye³

et al. 2009

Dig Dis

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“…Recently, hepatocyte-specific MR contrast agents such as gadoxetic acid-enhanced MRI and the inclusion of diffusionweighted imaging have made it possible to diagnose even small hepatocellular carcinomas (HCCs) (8 considered the optimal imaging modality because it has higher sensitivity and specificity than CT, CT still remains the "workhorse, " because of its lower cost and higher availability (7,9).…”

Section: Introductionmentioning

confidence: 99%

“…However, CT has problem with the interpretation of local marginal recurrences after chemoembolization, because of beam hardening artifact due to iodized oil (9).…”

Section: Introductionmentioning

confidence: 99%

Detection of Recurrent/Residual Hepatocellular Carcinoma: Single-Center Retrospective Comparative Study Between Parenchymal Blood Volume Mapping Using Cone Beam CT and Multiphase Dynamic CT

Kim

Kim²,

Han

et al. 2018

J Korean Soc Radiol

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Purpose:To evaluate the usefulness of cone beam computed tomography (CT)-based parenchymal blood volume (PBV) mapping for the detection of marginal recurrence or residual hepatocellular carcinoma, after transcatheter arterial chemoembolization (TACE), and to compare it with multiphase dynamic CT (MDCT). Materials and Methods: From March 2015 to October 2016, 26 patients with 49 iodized nodules who underwent TACE and a pre-interventional MDCT scan were enrolled in our study. We evaluated the diagnostic efficacies of PBV mapping using cone beam CT and MDCT in the detection of marginal recurrences or viable tumors. Results: The sensitivity, specificity, positive predictive value, and negative predictive value (NPV) of PBV mapping and MDCT were 100%, 96.7%, 94.7%, and 100%, and 77.9%, 93.5%, 87.5%, and 87.8%, respectively. The overall sensitivity for identifying local marginal recurrence was higher for PBV mapping than for MDCT (p < 0.005). The performances of PBV mapping and MDCT in the diagnosis of local marginal recurrence were significantly different (p = 0.037, McNemar test). Conclusion: Compared with MDCT, PBV mapping can significantly increase the detection of marginal recurrence or residual tumor after TACE because it is free of beam-hardening artifact. PBV mapping should be considered as a feasible modalityrelated tool for patients who have undergone chemoembolization. This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (https://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Index terms

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“…Microbubbles, developed as contrast agents for ultrasound, are considered useful for increasing the intensity of echoes [2][3][4]. Thus, contrast-enhanced ultrasound (CE-US) can depict intratumoral vascularity sensitively and accurately, and is considered useful for diagnosing hepatic tumors and assessing the therapeutic response in hepatocellular carcinoma (HCC) [5][6][7][8][9][10]. However, the pattern classification of tumor enhancement generally done in these CE-US studies is a qualitative analysis of blood flow for the evaluation of therapeutic response.…”

Section: Introductionmentioning

confidence: 99%

Quantification of tumor vascularity with contrast-enhanced ultrasound for early response of transcatheter arterial chemoembolization for hepatocellular carcinoma: a report of three cases

et al. 2011

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Many contrast-enhanced ultrasound (CE-US) studies have been conducted by qualitative analysis of blood flow, such as classification of enhancement pattern. We evaluated early response of transcatheter arterial chemoembolization (TACE) for hepatocellular carcinoma (HCC) by quantitative analysis of intratumoral vascularity with CE-US in three patients. Three patients (one man, two women) with HCCs were treated in July 2009. CE-US with perfluorocarbon microbubbles (Sonazoid) and CT were performed serially before and 5 days after TACE. Post-processing enhancement intensity on US was analyzed to determine mean transit time (s), time to peak (s), enhancement peak intensity (dB), and "A" (scaling factor) by ultrasound quantification software after the data were fitted to a gamma variate curve. Mean transit time was prolonged by TACE in all three patients. Mean transit time rates on CE-US were 64.3, 33.8, and 65.6%, respectively, whereas the avascular rates on CT were 59.07, 31.71, and 62.25%, respectively. Mean transit time rates on CE-US approximated avascular rates on CT. Mean transit time rate may quantitatively indicate the early response of HCC to TACE.

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Radiologic Monitoring of Hepatocellular Carcinoma Tumor Viability after Transhepatic Arterial Chemoembolization: Estimating the Accuracy of Contrast-enhanced Cross-sectional Imaging with Histopathologic Correlation

Cited by 63 publications

References 45 publications

Transcatheter Chemoembolization of Unresectable Hepatocellular Carcinoma: Current Knowledge and Future Directions

Transcatheter Chemoembolization of Unresectable Hepatocellular Carcinoma: Current Knowledge and Future Directions

Detection of Recurrent/Residual Hepatocellular Carcinoma: Single-Center Retrospective Comparative Study Between Parenchymal Blood Volume Mapping Using Cone Beam CT and Multiphase Dynamic CT

Quantification of tumor vascularity with contrast-enhanced ultrasound for early response of transcatheter arterial chemoembolization for hepatocellular carcinoma: a report of three cases

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