Dual phase cone-beam computed tomography in detecting <3 cm hepatocellular carcinomas during transarterial chemoembolization
Xiaodong Wang1, Hooman Yarmohammadi2, Guang Cao1, Xinqiang Ji3, Jungang Hu1, Hirad Yarmohammadi4, Hui Chen1, Xu Zhu1, Renjie Yang1, Stephen B Solomon2
1 Department of Interventional Radiology, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University Cancer Hospital and Institute, Beijing, China
2 Department of Radiology, Interventional Radiology Service, Memorial Sloan-Kettering Cancer Center, New York, USA
3 Department of Medical Statistics, Peking University Cancer Hospital and Institute, Beijing, China
4 Department of Medicine, University of Minnesota, Minneapolis, Minnesota, USA
Department of Radiology, Division of Interventional Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York 10065
Source of Support: None, Conflict of Interest: None
Objective: The objective of this study was to evaluate the sensitivity of dual phase cone-beam computed tomography (CBCT) in detecting small (<3 cm in diameter) hepatocellular carcinoma (HCC) tumors during transarterial chemoembolization (TACE).
Materials and Methods: Twenty-two consecutive patients with unresectable small HCCs in whom TACE was performed were retrospectively evaluated. Contrast CT or contrast magnetic resonance imaging (MRI) was performed in all patients within 1 month prior to the procedure. Dual phase CBCT was performed prior to TACE and lipiodol-CBCT was performed after treatment. The sensitivity of dual phase CBCT in detecting small HCCs was compared to hepatic angiography, contrast enhanced CT and MRI.
Results: Seventy HCC tumors with sizes of <3 cm were detected in 22 patients. Dual phase CBCT depicted 67 small tumors either on arterial or venous phase and was significantly more sensitive compared to hepatic angiography, contrast CT, or MRI (95.7%, 65.7%, and 71.4%, respectively; P < 0.001).
Conclusions: Dual phase CBCT is significantly more sensitive than hepatic angiography, contrast enhanced CT, and MRI in detecting smaller than 3 cm HCC tumors and can be a helpful modality in making accurate planning for treatment of HCC.