3:27 PM Abstract No. 134 Is smaller better for hepatocellular carcinoma? Evaluation of DEB-TACE bead size and cTACE in 142 explanted tumors

The value of intra-procedural transcatheter intraarterial contrast-enhanced ultrasonography (IA-CEUS) in predicting the short-term efficacy of conventional transarterial chemoembolization (cTACE)

“…Clinically, the interventional effect assessed by mRECIST is used to replace pathological examination, but the disadvantage is that the waiting time is long and it is impossible to determine the curative effect and take further effective measures in time. The endpoint of embolization or technical success rate in interventional tumor surgery is closely correlated to its short-term and long-term effects ( 4 , 13 ). The early and accurate determination of embolization is of great significance to take effective measures in time and improve the short-term and long-term efficacy ( 14 , 15 ).…”

“…The retention of contrast agent in the local artery and intratumoral perfusion after arterial embolization are the main technical indices for imaging prediction of short-term and long-term effects. It is the most common method to predict the long-term effect of cTACE by observing the retention of contrast agent under fluoroscopy during an interventional operation (that is, DSA), the disadvantage is that it does not take into account the changes of tumor perfusion and drug distribution; due to the limitations of imaging technology, results are subjective and variable ( 4 , 17 , 18 ). DSA combined with CBCT and MRI to evaluate the local tumor perfusion changes post-cTACE to predict short-term efficacy has become the main technical means at present ( 11 , 18 ).…”

“…Conventional transarterial chemoembolization (cTACE) is the standard treatment for HCC patients in Barcelona Clinic Liver Cancer (BCLC) stage B and can significantly improve the survival rate of patients ( 1 - 3 ). Although the overall survival time remains the best evaluation index for cTACE in clinical trials, image biomarkers are often used to replace the overall survival time to predict the short-term and long-term efficacy of cTACE ( 4 - 7 ). Therefore, it is of great clinical significance to select appropriate image biomarkers for the early and accurate evaluation of the embolization effect of cTACE for selecting an appropriate follow-up treatment regimen.…”

“…Compared with intravenous CEUS, digital subtraction angiography (DSA), multidetector CT (MDCT), cone-beam computed tomography (CBCT), and magnetic resonance imaging (MRI), IA-CEUS can dynamically observe the change of microcirculation of the whole tumor of HCC in real-time, including the changes in blood flow from the artery to the tumor, intratumoral perfusion, and the local drainage area around the tumor. However, the change of tumor microcirculation after TACE is closely related to the success rate of embolization, short-term and long-term curative effects, and recurrence ( 4 , 11 , 12 ). Therefore, it is of great clinical significance in predicting a curative effect to observe the changes of tumor microcirculation with IA-CEUS immediately after TACE.…”