The Impact of the Use of C-Arm Cone-Beam CT During Chemoemboliza-tion for Hepatocellular Carcinoma

Mohamed E. Abdelsalam, Tomas M.A. Figueira, Joe Ensor, Alda L. Tam, Rony Avritscher, Ahmed Kaseb, Sanjay Gupta

Research output: Contribution to journalArticlepeer-review

Abstract

Objective: The objective of the study was to investigate the consequences of using C-Arm Cone-Beam computed Tomography (CBCT) on super-selective catheterization of Hepatic Artery (HA) branches during chemoembolization of hepatocellular carcinoma. Methods: Two groups of patients were created according to the dates of their treatment sessions. Group A and Group B included patients who had their treatment sessions in 2004-2005 and 2008-2010, respectively. The sessions performed in 2006 and 2007 were excluded to allow for the adop-tion and incorporation of CBCT imaging into clinical practice. All chemoembolized HA branches were categorized according to selection order (0-1, 2, or ≥3). Other procedure variables were docu-mented. Results: A total of 58 and 183 sessions were included in Groups A and B, respectively, for 144 pa-tients. C-arm CBCT was used in 2 (3%) sessions and 142 (78%) sessions in groups A and B, re-spectively. The average number of vessels treated was significantly higher in group B (1.8) compared to group A (1.3) (P < .0001). A shift to an increased selection order in group B (0-1, 44 [24%]; 2, 85 [46%]; ≥3, 54 [30%]) was more significant (P = .0004) than that in group A (0-1, 32 [55%]; 2, 18 [31%]; ≥3, 8 [14%]). The average duration of the procedure was significantly longer in group B (P = .0002). Conclusion: Using C-arm CBCT during chemoembolization has a positive impact on increasing the number and order of HA selected and chemoembolized. This comes at the expense of an increase in the duration of the procedure.

Original languageEnglish (US)
Pages (from-to)372-380
Number of pages9
JournalCurrent Medical Imaging Reviews
Volume18
Issue number4
DOIs
StatePublished - Apr 2022

Keywords

  • Cone-beam CT
  • HCC
  • TACE
  • chemoembolization
  • hepatic artery
  • subselective catheterization

ASJC Scopus subject areas

  • Internal Medicine
  • Radiology Nuclear Medicine and imaging

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