Iodized Oil Accumulation in Hypervascular Hepatocellular Carcinoma after Transcatheter Arterial Chemoembolization: Comparison of Imaging Findings with CT during Hepatic Arteriography

Fujita, Takeshi; Ito, Katsuyoshi; Tanabe, Masahiro; Yamatogi, Shigenari; Sasai, Hideko; Matsunaga, Naofumi

doi:10.1016/j.jvir.2007.10.020

Cited by 21 publications

(8 citation statements)

References 18 publications

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“…In relation to this, a discrepancy was noted between the tumor enhancement on selective CTHA with balloon occlusion and a dense LE accumulation after B-TACE, which was higher than the tumor enhancement grade[ 31 ]. Although CBCT[ 33 - 35 ] and CTHA[ 36 , 37 ] are well known to be useful tools for identifying the tumor-feeding arteries, evaluating the embolized area and avoiding nontargeted embolization, the same findings were reported in selective C-TACE[ 38 ]. A validation study will be needed to confirm whether or not a decreased tumor enhancement after balloon occlusion can predict the short- and long-term therapeutic effects.…”

Section: Mechanism Of B-tacementioning

confidence: 99%

Balloon-occluded transcatheter arterial chemoembolization for hepatocellular carcinoma

Hatanaka¹,

Arai²,

Kakizaki³

2018

WJH

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Transcatheter arterial chemoembolization (TACE) is widely accepted as a treatment for patients with hepatocellular carcinoma (HCC) in the intermediate stage according to the Barcelona Clinic Liver Cancer (BCLC) guidelines. Recently, balloon-occluded TACE (B-TACE) was developed in Japan. Despite the lack of a clear definition, B-TACE is generally defined as the infusion of emulsion of chemotherapeutic agents with lipiodol followed by gelatin particles under the occlusion of feeding arteries by a microballoon catheter, which leads to the dense lipiodol emulsion (LE) accumulation in HCC nodules. This phenomenon cannot be explained only by the prevention of proximal migration and leakage of embolization materials; it further involves causing local changes in the hemodynamics of the surrounding occlusion artery and targeted HCC nodules. Balloon-occluded arterial stump pressure plays an important role in the dense LE accumulation in targeted HCC nodules. Although randomized controlled trials comparing the therapeutic effect and the prognosis of B-TACE to those of the other TACE procedures, such as conventional-TACE and drug-eluting beads TACE, are still lacking, B-TACE is thought to be a promising treatment. The purpose of this review is to summarize the mechanism, therapeutic effect, indication, prognosis and complications of B-TACE.

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Section: Mechanism Of B-tacementioning

confidence: 99%

Balloon-occluded transcatheter arterial chemoembolization for hepatocellular carcinoma

Hatanaka¹,

Arai²,

Kakizaki³

2018

WJH

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“…High concentrations of the drug-delivery vehicle lipiodol in the tumor at the time of treatment are associated with lower risks of local tumor recurrence [14] . MPT (cis-[((1R, 2R)-1, 2-cyclohexanediamine-N, N0)bis(-myristato)]-platinum(II) monohydrate; Sumitomo Dainippon Pharma Co., Ltd., Osaka, Japan) is a novel lipophilic cisplatin derivative that can be suspended in lipiodol [3,15,16] .…”

Section: Discussionmentioning

confidence: 99%

Hemodynamic Changes on Cone-Beam Computed Tomography during Balloon-Occluded Transcatheter Arterial Chemoembolization Using Miriplatin for Hepatocellular Carcinoma: A Preliminary Study

Ishikawa

Imai²,

Owaki³

et al. 2017

Dig Dis

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Background/Aim: Balloon-occluded transcatheter arterial chemoembolization (B-TACE) using miriplatin (MPT) is anticipated as a new strategy for hepatocellular carcinoma (HCC). This study was aimed at evaluating the hemodynamic changes with/without balloon occlusion of the hepatic artery, correlation of cone-beam CT (CBCT) pixels, and CT value after B-TACE for HCC. Methods: A total of 52 patients with HCC, who underwent B-TACE using MPT in addition to the balloon-occluded CBCT hepatic arteriography, were studied. Results: After balloon occlusion, CBCT pixel values increased in 37 lesions, whereas it decreased in 15 lesions. Intratumoral CT values after B-TACE were lower with decreased CBCT pixel values than with increased CBCT pixel values. Conclusion: Hemodynamic changes on CBCT during balloon occlusion can be used to predict the efficacy of B-TACE using MPT.

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“…For example, if DCR is identified, other blood vessels (hepatic or nonhepatic) can be interrogated to determine if they supply the tumor, or ablation of the underembolized portion of the tumor could be performed. Spasm resulting from guidewire or catheter manipulation in a feeding vessel is another potential cause of a defect in contrast retention and embolization failure [21]. This could be considered at the time of treatment, if DCR is identified, and potentially reversed with vasodilators.…”

Section: Discussionmentioning

confidence: 99%

Pattern of Retained Contrast on Immediate Postprocedure Computed tomography (CT) After Particle Embolization of Liver Tumors Predicts Subsequent Treatment Response

Wang

Erinjeri

Jia

et al. 2012

Cardiovasc Intervent Radiol

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Purpose To determine if the pattern of retained contrast on immediate postprocedure computed tomography (CT) after particle embolization of hepatic tumors predicts modified Response Evaluation Criteria in Solid Tumors (mRECIST) response. Materials and Methods This study was approved by the Institutional Review Board with a waiver of authorization. One hundred four liver tumors were embolized with spherical embolic agents (Embospheres, Bead Block, LC Bead) and polyvinyl alcohol. Noncontrast CT was performed immediately after embolization to assess contrast retention in the targeted tumors, and treatment response was assessed by mRECIST criteria on follow-up CT (average time 9.0 ± 7.7 weeks after embolization). Tumor contrast retention (TCR) was determined based on change in Hounsfield units (HUs) of the index tumors between the preprocedure and immediate postprocedure scans; vascular contrast retention (VCR) was rated; and defects in contrast retention (DCR) were also documented. The morphology of residual enhancing tumor on follow-up CT was described as partial, circumferential, or total. Association between TCR variables and tumor response were assessed using multivariate logistic regression. Results Of 104 hepatic tumors, 51 (49 %) tumors had complete response (CR) by mRECIST criteria; 23 (22.1 %) had partial response (PR); 21 (20.2 %) had stable disease (SD); and 9 (8.7 %) had progressive disease (PD). By multivariate analysis, TCR, VCR, and tumor size are independent predictors of CR (p = 0.02, 0.05, and 0.005 respectively). In 75 tumors, DCR was found to be an independent predictor of failure to achieve complete response (p <0.0001) by imaging criteria. Conclusion TCR, VCR, and DCR on immediate post-treatment CT are independent predictors of CR by mRECIST criteria.

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Iodized Oil Accumulation in Hypervascular Hepatocellular Carcinoma after Transcatheter Arterial Chemoembolization: Comparison of Imaging Findings with CT during Hepatic Arteriography

Cited by 21 publications

References 18 publications

Balloon-occluded transcatheter arterial chemoembolization for hepatocellular carcinoma

Balloon-occluded transcatheter arterial chemoembolization for hepatocellular carcinoma

Hemodynamic Changes on Cone-Beam Computed Tomography during Balloon-Occluded Transcatheter Arterial Chemoembolization Using Miriplatin for Hepatocellular Carcinoma: A Preliminary Study

Pattern of Retained Contrast on Immediate Postprocedure Computed tomography (CT) After Particle Embolization of Liver Tumors Predicts Subsequent Treatment Response

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