Utility of C-Arm CT in Detection Hepatocellular Carcinoma during Trans Arterial Chemoembolization

Abstract Background Transcatheter arterial chemoembolization is one of the effective therapeutic options for hepatocellular carcinoma (HCC). Ultraselective chemoembolization is an alternative approach to improve local control, and is associated with a reduced incidence of adverse effects. Objective It was to evaluate the sensitivity of cone beam computed tomography (CBCT) in detecting HCC tumors and their feeding vessels during transarterial chemoembolization (TACE). Patients and Methods All patients were suspected of having or confirmed to have HCC on the basis of clinical history, underlying liver disease and/or viral infection, the diagnosis of HCC was made by imaging findings. Between January 2016 and January 2018, Dyna CT was retrospectively used in 19 consecutive patients with HCC tumor with HCC tumor. Results The detectability of the tumor with DSA obtained at the common, proper, right, or left hepatic artery (i.e., nonselective DSA) and cone-beam CT was compared as taking pre imaging as a gold standard. Tumor stain and feeding branches were evaluated. The detectability of the tumor-feeding branch with non-selective DSA and Dyna CT HA images was compared. Conclusion Tumor detectability on cone-beam CT was significantly greater than on non-selective. Cone beam HA taking pre imaging as a gold standard was (94.4%) and its specificity (71.6%) with accuracy (76.97%). The sensitivity of DSA in detection of additional tumor as taking the pre imaging (CT/MRI) as a gold standard was (88.9%) and its specificity (84.5%) with accuracy (85.53%). Cone-beam CT has satisfactory ability to detect tumors; the detectability of tumor-feeding branches with Dyna CT was significantly higher than that with nonselective DSA (P less than 0.001). We believe the technical success rates of ultraselective transcatheter arterial chemoembolization may be improved by chemoembolization guidance software that uses cone-beam CT technology.