Transcatheter Arterial Chemoembolization for Hepatocellular Carcinoma: Prospective Assessment of the Right Inferior Phrenic Artery with C-arm CT
Received 9 July 2008; received in revised form 26 March 2009; accepted 30 March 2009. published online 28 May 2009.
Purpose
To assess the usefulness of C-arm computed tomography (CT) of the right inferior phrenic artery (RIPA) in transcatheter arterial chemoembolization of patients with hepatocellular carcinoma (HCC).
Materials and Methods
From December 2007 to April 2008, C-arm CT of the RIPA was prospectively performed in 32 patients with HCC. Two interventional radiologists who performed C-arm CT assessed the additional information provided with C-arm CT as grade 1 (no additional information), grade 2 (added information without an effect on the treatment plan), or grade 3 (added information with an effect on the treatment plan). Tumor feeders and feeders of a systemic-to-pulmonary shunt were recorded.
Results
The information provided by C-arm CT was classified as grade 1 for nine of the 32 patients (28%), grade 2 for 20 patients (63%), and grade 3 for three patients (9%). The most common additional information from C-arm CT scans of the RIPA was the differentiation between the tumor and the systemic-to-pulmonary shunt. A systemic-to-pulmonary shunt from the RIPA was observed in 22 patients (69%), and the most common feeder of a systemic-to-pulmonary shunt was the azygoesophageal branch.
Conclusions
C-arm CT of the RIPA provides additional imaging information for the differentiation of a tumor from a nontumorous condition during chemoembolization for HCC with a suspected blood supply from an RIPA.
aDepartment of Radiology, Seoul National University College of Medicine, Institute of Radiation Medicine, Seoul National University Medical Research Center, and Clinical Research Institute, Seoul National University Hospital, #28 Yongon-dong, Chongno-gu, Seoul, 110-744, Korea
bDepartment of Radiology, SMG-SNU Boramae Medical Center, Seoul, Korea
Address correspondence to J.W.C.
None of the authors have identified a conflict of interest.
ABSTRACT