Long Gao, Presenter: Nothing to Disclose

Hai Bo Shao MD, Abstract Co-Author: Nothing to Disclose

Tengchuang Ma, Abstract Co-Author: Nothing to Disclose

Xu Ke MD, Abstract Co-Author: Nothing to Disclose

To evaluate the efficacy of cone-beam computed tomography (CBCT) with three-dimensional (3D) reconstruction techniques in transcatheter arterial chemoembolization (TACE) for hepatocellular carcinoma (HCC) compared with conventional digital substruction angiography (cDSA).

This retrospective study was performed on 36 consecutive HCC patients who underwent super-selective TACE. CBCT was performed on 16 patients (35 tumors). 3D-angiography, 3D-roadmap and multi-planar reconstruction techniques were used to guide operation and evaluate embolization efficacy. The other 20 patients (44 tumors) received cDSA during TACE. Distinguishability of feeding arteries, detectability of HCC lesions, technical success of super-selective catheterization, operating time, cumulative X-ray exposure of patient, dosage of contrast agent (CA) and lipiodol depositing proportion (one-month postoperative contrast-enhanced CT as reference standard) were compared between groups.

All TACE procedures were carried out fluently. There were no severe procedure related complications. All patients received one-month CT follow-up. CBCT with 3D techniques showed better efficacy in showing feeding arteries (87.5% vs. 55%, p<0.01), detectability of HCC lesions (97.14%, 34 of 35 vs. 70.45 %, 31 of 44, p=0.028) and technical success rate of super-selective catheterization (91% vs. 75%, p=0.043) than cDSA. Moreover, procedures with CBCT spent less CAs (28 vs. 36 ml, p=0.44). However, procedures with CBCT spent longer operating time (43 vs. 32 mins, p<0.01) and induced more X-ray dosage exposure (242 vs. 157 mGy, p=0.015) than those with cDSA. On lipiodol depositing evaluation, the coincidence rate of CBCT with one-month CT follow-up was significantly higher than that of cDSA (100% vs. 76%, p<0.01).

Compared with cDSA, CBCT with 3D reconstruction techniques showed better clinical application efficacy in feeding artery distinguishability, tumor detectability, catheterization guidance and embolism efficacy evaluation in TACE for HCC patients although consuming more operating time and X-ray exposure.

Application of CBCT with 3D reconstruction techniques may have potentially encouraging values in improving the efficacy of TACE for HCC patients.

Gao, L, Shao, H, Ma, T, Ke, X, Cone-beam Computed Tomography with Three-dimensional Reconstruction Techniques versus Conventional Digital Substruction Angiography in Transcatheter Arterial Chemoembolization for Hepatocellular Carcinoma.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14045507.html