Making timely remedial measures after TACE based on the results of cone-beam CT liver perfusion

International Journal of Hyperthermia

DeChao Jiao¹  Xinwei Han¹  Yahua Li¹  Wenguang Zhang¹  Zaoqu Liu¹  Xueliang Zhou¹  Juanfang Liu¹  Jin Li¹  Zhaonan Li¹  Guangyan Si² 

[1] Department of Interventional Radiology, First Affiliated Hospital of Zhengzhou University;Department of Interventional Radiology, The Affiliated Hospital of Traditional Chinese Medicine of Southwest Medical University;

关键词: hepatocellular carcinoma;    microwave ablation;    interventional radiology;    transcatheter arterial chemoembolization;   

DOI  :  10.1080/02656736.2021.1895331

来源: DOAJ

【 摘 要 】

Objective To evaluate the feasibility and safety of using cone-beam CT (CBCT) to measure changes in parenchymal blood volume (PBV) of patients with hepatocellular carcinoma (HCC) after transcatheter arterial chemoembolization (TACE) and to guide microwave ablation (MWA) for residual tumors. Methods A retrospective study was performed on 42 patients with HCC who completed TACE and received CBCT-guided perfusion imaging. The residual active lesions after TACE were supplemented with MWA to complete the treatment process according to the residual PBV. The outcomes were analyzed, including PBV changes, interventional-related complications, local tumor progression (LTP) and overall survival (OS). Results Technical success was achieved in all lesions. Correlation analysis revealed that greater volume of residual PBV after MWA is negatively correlated with LTP. (p = .000); and the decrease of PBV was positively correlated with LTP (p = .000). All adverse events and complications were CTCAE Grade 1/2. After combination treatment, the 1-, 3-, and 5-year LTP-free survival were 97.6%, 69.0% and 15.1%, respectively, with a median LTP of 49.0 months (95% CI:43.129,54.871). Multivariate Cox regression revealed that the residual PBV > 13 ml/1000 was an independent factor predicting a shorter OS and LTP (Both p< .05). For LTP, multivariate Cox regression showed that a tumor in a single lesion were independently predicted to have a longer LTP in patients with HCC (p = .033). Conclusion CBCT is feasible and safe to use to measure changes in the PBV before and after TACE treatment, while it can also guide MWA for the treatment of residual tumors in one session

【 授权许可】

Unknown