Ultraselective transcatheter arterial chemoembolization for small hepatocellular carcinoma guided by automated tumor-feeders detection software: technical success and short-term tumor response

Abstract

AFD software has sufficient performance to identify tumor-feeders and contributes to the high technical success in ultraselective TACE.

Efficacy of Automated Tumor-Feeder Detection Software Using Cone-Beam Computed Tomography Technology in Transarterial Targeted Therapy

“…Second, the identified branch is infrequently mistraced mainly at the proximal site (Fig. 10) [3]. Artifacts from contrast material may be a cause of this phenomenon.…”

“…In 11% of tumors, the entire tumor was embolized but the safety margin was not uniformly obtained in parts. However, the entire tumor could not be embolized in 6.5% of tumors [3].…”

“…A suspected feeding branch can also be manually highlighted by clicking it on CBCTA images. The total time required for the analysis of tumor feeders after the acquisition of CBCTA images is less than approximately 2 minutes [1,3,4].…”

“…Fluoroscopic times for unnecessary catheterization can also be avoided, and the risk of vascular injury during catheter-guidewire manipulation can be prevented. Second, the AFD software can identify the feeders supplying the safety margin [3]. To perform TACE effectively, embolization of all branches supplying not only the tumor but also the safety margin is important.…”

“…The three-dimensional (3-D) imaging data of CBCT can also be used not only for lesion detection but also for 3-D vessel tracking. The automated tumor-feeder detection (AFD) software is a new tool and is now being used in transarterial targeted therapies [3][4][5][6][7][8], mainly in TACE for hepatocellular carcinoma (HCC).…”