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. 2012 Oct;22(4):254-6.
doi: 10.4103/0971-3026.111472.

Selective doxorubicin drug eluting beads chemoembolization of hypovascular hepatocellular carcinoma using cone beam computed tomography

Naveen Kalra  1 , Divyesh Mahajan, Yogesh Chawla, N Khandelwal
Affiliations

Selective doxorubicin drug eluting beads chemoembolization of hypovascular hepatocellular carcinoma using cone beam computed tomography

Naveen Kalra et al. Indian J Radiol Imaging. 2012 Oct.

Abstract

Hepatocellular carcinoma (HCC) of the liver is the third most common cause of cancer-related deaths in the world. Only one-third of patients with HCC are suitable candidates for hepatic resection. Transarterial chemoembolization (TACE) is performed in unresectable HCC. Drug-eluting beads (DEB) TACE is a modification of TACE, in which doxorubicin beads are used as embolizing material. These beads deliver the drug and embolize the vessels; however, it carries the risk of non-target embolization and it is difficult in cases with absent arterial blush on digital subtraction angiography (DSA). This is resolved using C-arm cone-beam computed tomography in the DSA suite. It identifies the tumor-feeding vessels, their area of supply, and differentiates between tumor and normal liver parenchyma. In addition, it is very useful in the embolization of hypovascular HCC. It helps and guides the radiologist in performing TACE effectively and also prevents non-target embolization of normal liver parenchyma.

Keywords: Cone-beam computed tomography; hepatocellular carcinoma; transarterial chemoembolization.

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Conflict of interest statement

Conflict of Interest: None declared.

Figures

Figure 1
Figure 1
Contrast-enhanced computed tomography scan of the liver. Arterial phase image shows (A) hypodense exophytic lesion in segments five and eight of the liver, with minimal enhancement. Venous phase image shows (B) no washout or enhancement of the mass lesion in the portal venous phase
Figure 2
Figure 2
Selective catheterization of the right hepatic artery shows no abnormal tumor blush
Figure 3
Figure 3
Super-selective catheterization of the medial-most branch of the right hepatic artery shows (A) minimal abnormal blush that did not conform to the vascular territory of the tumor;XperCT™ run shows (B) that the catheterized vessel exclusively supplies the normal uninvolved hepatic parenchyma
Figure 4
Figure 4
Super-selective catheterization of the middle branch of the right hepatic artery shows (A) minimal tumoral blush;XperCT™ confirm the catheterization of the abnormal vessel, which is seen (B) to supply the tumor bed
Figure 5
Figure 5
Follow-up contrast-enhanced computed tomography shows almost complete tumor necrosis
See this image and copyright information in PMC

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