Angio-Computed Tomograph-Guided Immediate Lipiodol Computed Tomograph for Diagnosis of Small Hepatocellular Carcinoma Lesions During Transarterial Chemoembolization

Overview

Journal Chin Med J (Engl)

Specialty General Medicine

Date 2018 Oct 19

PMID 30334525

Citations 4

Authors

Feng-Yong Liu

Xin Li

Hong-Jun Yuan

Yang Guan

Mao-Qiang Wang

Affiliations

Soon will be listed here.

Abstract

Background: The diagnosis and treatment of small hepatocellular carcinoma (HCC) play a vital role in the prognosis of patients with HCC. The purpose of our study was to evaluate angio-computed tomography (angio-CT)-guided immediate lipiodol CT (a CT scan performed immediately after transarterial chemoembolization [TACE]) in the diagnosis of potential HCCs ≤1 cm in diameter.

Methods: This study retrospectively analyzed 31 patients diagnosed with HCCs after routine imaging (contrast-enhanced CT or magnetic resonance imaging) or pathologic examinations with undefined or undetermined tumor lesions (diameter ≤1 cm) from February 2016 to September 2016. After TACE guided by digital subtraction angiography of the angio-CT system, potential HCC lesions with a diameter ≤1 cm were diagnosed by immediate lipiodol CT. The number of well-demarcated lesions was recorded to calculate the true positive rate. The correlation between the number of small HCCs detected by immediate lipiodol CT and the size of HCC lesions (diameter >1 cm) diagnosed preoperatively was analyzed 1 month after TACE. A paired t-test was used to analyze differences in liver function. Pearson analysis was used to analyze correlation. Chi-square test was used to compare the rates.

Results: Fifty-eight lesions were detected on preoperative routine imaging examinations in 31 patients including 15 lesions with a diameter ≤1 cm. Ninety-one lesions were detected on immediate lipiodol CT, of which 48 had a diameter ≤1 cm. After 1 month, CT showed that 45 lesions had lipiodol deposition and three lesions had lipiodol clearance. Correlation analysis showed that the number of small HCCs detected by lipiodol CT was positively correlated with the size of HCC lesions diagnosed by conventional imaging examination (R = 0.54, P < 0.05).

Conclusion: Immediate lipiodol CT may be a useful tool in the diagnosis of potential HCC lesions with a diameter of ≤1 cm.

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References

Dahiya D, Wu T, Lee C, Chan K, Lee W, Chen M . Minor versus major hepatic resection for small hepatocellular carcinoma (HCC) in cirrhotic patients: a 20-year experience. Surgery. 2009; 147(5):676-85. DOI: 10.1016/j.surg.2009.10.043. View

Hirota S, Nakao N, Yamamoto S, Kobayashi K, Maeda H, Ishikura R . Cone-beam CT with flat-panel-detector digital angiography system: early experience in abdominal interventional procedures. Cardiovasc Intervent Radiol. 2006; 29(6):1034-8. DOI: 10.1007/s00270-005-0287-6. View

Ronot M, Vilgrain V . Hepatocellular carcinoma: diagnostic criteria by imaging techniques. Best Pract Res Clin Gastroenterol. 2014; 28(5):795-812. DOI: 10.1016/j.bpg.2014.08.005. View

Chen R, Geschwind J, Wang Z, Tacher V, Lin M . Quantitative assessment of lipiodol deposition after chemoembolization: comparison between cone-beam CT and multidetector CT. J Vasc Interv Radiol. 2013; 24(12):1837-44. PMC: 3840104. DOI: 10.1016/j.jvir.2013.08.017. View

Floriani I, DOnofrio M, Rulli E, Chen M, Li R, Musicco L . Performance of imaging modalities in the diagnosis of hepatocellular carcinoma: a systematic review and meta-analysis. Ultraschall Med. 2012; 34(5):454-62. DOI: 10.1055/s-0032-1330358. View

Loffroy R, Lin M, Rao P, Bhagat N, Noordhoek N, Radaelli A . Comparing the detectability of hepatocellular carcinoma by C-arm dual-phase cone-beam computed tomography during hepatic arteriography with conventional contrast-enhanced magnetic resonance imaging. Cardiovasc Intervent Radiol. 2011; 35(1):97-104. DOI: 10.1007/s00270-011-0118-x. View

Lencioni R, De Baere T, Soulen M, Rilling W, Geschwind J . Lipiodol transarterial chemoembolization for hepatocellular carcinoma: A systematic review of efficacy and safety data. Hepatology. 2016; 64(1):106-16. DOI: 10.1002/hep.28453. View

Monsky W, Kim I, Loh S, Li C, Greasby T, Deutsch L . Semiautomated segmentation for volumetric analysis of intratumoral ethiodol uptake and subsequent tumor necrosis after chemoembolization. AJR Am J Roentgenol. 2010; 195(5):1220-30. DOI: 10.2214/AJR.09.3964. View

Luca A, Caruso S, Milazzo M, Mamone G, Marrone G, Miraglia R . Multidetector-row computed tomography (MDCT) for the diagnosis of hepatocellular carcinoma in cirrhotic candidates for liver transplantation: prevalence of radiological vascular patterns and histological correlation with liver explants. Eur Radiol. 2009; 20(4):898-907. DOI: 10.1007/s00330-009-1622-0. View

10.

Zheng X, Guan Y, Zhou X, Huang J, Sun L, Li X . Detection of hypervascular hepatocellular carcinoma: Comparison of multi-detector CT with digital subtraction angiography and Lipiodol CT. World J Gastroenterol. 2005; 11(2):200-3. PMC: 4205401. DOI: 10.3748/wjg.v11.i2.200. View

11.

Li T, Fan J, Qin L, Zhou J, Sun H, Qiu S . Risk factors, prognosis, and management of early and late intrahepatic recurrence after resection of primary clear cell carcinoma of the liver. Ann Surg Oncol. 2011; 18(7):1955-63. DOI: 10.1245/s10434-010-1540-z. View

12.

. EASL Clinical Practice Guidelines: Management of hepatocellular carcinoma. J Hepatol. 2018; 69(1):182-236. DOI: 10.1016/j.jhep.2018.03.019. View

13.

Zhou W, Lai E, Li A, Fu S, Zhou J, Pan Z . A prospective, randomized, controlled trial of preoperative transarterial chemoembolization for resectable large hepatocellular carcinoma. Ann Surg. 2009; 249(2):195-202. DOI: 10.1097/SLA.0b013e3181961c16. View

14.

Rizvi S, Camci C, Yong Y, Parker G, Shrago S, Stokes K . Is post-Lipiodol CT better than i.v. contrast CT scan for early detection of HCC? A single liver transplant center experience. Transplant Proc. 2006; 38(9):2993-5. DOI: 10.1016/j.transproceed.2006.08.125. View

15.

Song K, Kim S, Lim H, Jung S, Sohn I, Kim H . Subcentimeter hypervascular nodule with typical imaging findings of hepatocellular carcinoma in patients with history of hepatocellular carcinoma: natural course on serial gadoxetic acid-enhanced MRI and diffusion-weighted imaging. Eur Radiol. 2015; 25(9):2789-96. DOI: 10.1007/s00330-015-3680-9. View

16.

Nakayama A, Imamura H, Matsuyama Y, Kitamura H, Miwa S, Kobayashi A . Value of lipiodol computed tomography and digital subtraction angiography in the era of helical biphasic computed tomography as preoperative assessment of hepatocellular carcinoma. Ann Surg. 2001; 234(1):56-62. PMC: 1421948. DOI: 10.1097/00000658-200107000-00009. View

17.

Xu L, Peng Z, Chen M, Shi M, Zhang Y, Guo R . Prognostic nomogram for patients with unresectable hepatocellular carcinoma after transcatheter arterial chemoembolization. J Hepatol. 2015; 63(1):122-30. DOI: 10.1016/j.jhep.2015.02.034. View

18.

Hu J, Maybody M, Cao G, Wang X, Chen H, Zhu X . Lipiodol retention pattern assessed by cone beam computed tomography during conventional transarterial chemoembolization of hepatocellular carcinoma: accuracy and correlation with response. Cancer Imaging. 2016; 16(1):32. PMC: 5048686. DOI: 10.1186/s40644-016-0090-4. View

19.

Yu M, Kim J, Yoon J, Kim H, Chung J, Han J . Role of C-arm CT for transcatheter arterial chemoembolization of hepatocellular carcinoma: diagnostic performance and predictive value for therapeutic response compared with gadoxetic acid-enhanced MRI. AJR Am J Roentgenol. 2013; 201(3):675-83. DOI: 10.2214/AJR.12.10445. View

20.

Miyayama S, Yamashiro M, Hashimoto M, Hashimoto N, Ikuno M, Okumura K . Identification of small hepatocellular carcinoma and tumor-feeding branches with cone-beam CT guidance technology during transcatheter arterial chemoembolization. J Vasc Interv Radiol. 2013; 24(4):501-8. DOI: 10.1016/j.jvir.2012.12.022. View