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. 2012 Feb;74(1):91-9.
doi: 10.1007/s12262-011-0377-4. Epub 2011 Dec 13.

Interventional radiological treatment of hepatocellular carcinoma: an update

Anurag Shrimal  1 , Madhu Prasanth, A V Kulkarni
Affiliations

Interventional radiological treatment of hepatocellular carcinoma: an update

Anurag Shrimal et al. Indian J Surg. 2012 Feb.

Abstract

Hepatocellular carcinoma is the commonest primary liver tumor and its incidence is on an increase.Transplantation and surgical resection are the gold standard curative treatment options but less than 20%patients are surgical candidates because of advanced liver disease and/or co-morbidities.Various interventional radiological procedures have been developed and intensively investigated for treatment of inoperable HCC.This review summarizes the various interventional radiological treatments in HCC including patient selection, procedural considerations and response evaluation. Transarterial chemoembolization, radioembolization and radiofrequency ablation are mainly discussed.

Keywords: HCC; Interventional radiological treatments; Radioembolization; Radiofrequency ablation; TACE.

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Figures

Fig. 1
Fig. 1
a Axial CT scan showing arterial phase enhancing lesion in segment V of right lobe of liver with an adjacent satellite nodule. b Tumor blush after superselective cannulation of feeding vessel. c Postchemoembolization angiogram showing complete obliteration of neoplastic vascularity. d Response evaluation CT scan confirms lipiodol deposition in tumor with sparing of surrounding normal parenchyma
Fig. 2
Fig. 2
Right inferior phrenic angiogram demonstrating parasitazion of blood supply by large left lobe HCC
Fig. 3
Fig. 3
a Axial CT scan shows large heterogeneous mass in the right lobe of liver (black arrow) with main portal vein thrombosis (white arrow). b Coronal CT scan shows enhancing tumor thrombus in the right branch of portal vein (white arrow) and a nonenhancing thrombus in main portal vein (black arrow). c Response evaluation CT scan shows complete necrosis of the right lobe HCC with recanalization of the portal vein
Fig. 4
Fig. 4
a Axial CT scan showing heterogeneous mass in the left lobe of the liver with thrombosis of the left portal vein. b Digital subtraction angiogram (planning angiogram) shows variant arterial supply to the left lobe of the liver in the form of accessory left hepatic artery arising from left gastric artery. Note branches supplying the tumor (white arrow) and branches supplying the stomach (black arrow). c Coil embolization of branches supplying stomach to skeletonize blood supply to tumor. d Response evaluation CT scan after radioembolization shows complete necrosis of the left lobe tumor (white arrow)
Fig. 5
Fig. 5
a Axial CT scan shows arterial phase enhancing lesion in the right lobe of the liver. b CT-guided RFA using multitined expandable electrode. c Post-RFA response evaluation CT scan shows complete lack of enhancement within the tumor representing good response
See this image and copyright information in PMC

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