Segmental transcatheter arterial embolization for primary hepatocellular carcinoma

Area of Science:

• Interventional Radiology
• Hepatobiliary Oncology
• Vascular Imaging

Background:

• Primary hepatocellular carcinoma (HCC) is a significant global health concern.
• Non-resectable HCC presents therapeutic challenges.
• Transcatheter arterial embolization (TAE) is a key treatment modality for HCC.

Purpose of the Study:

• To assess the therapeutic efficacy of segmental TAE for primary HCC.
• To characterize the imaging appearance and clinical significance of lipiodol overflow into portal veins.
• To evaluate lipiodol overflow as an indicator of treatment success.

Main Methods:

• Retrospective analysis of 50 patients with non-resectable primary HCC.
• Segmental TAE performed using superselective catheterization techniques (wire-guiding and coaxial infusion).
• Evaluation of lipiodol distribution, including overflow into portal veins, and patient survival rates.

Main Results:

• 1-, 2-, 3-, and 4-year cumulative survival rates were 83.8%, 65.4%, 42.9%, and 24.5%, respectively.
• Lipiodol overflow into portal veins occurred in 64% of cases.
• Overflow patterns were star-like or tree-like, indicating embolization of portal venous supply.

Conclusions:

• Segmental TAE demonstrates therapeutic value in managing primary HCC.
• Lipiodol overflow into portal veins is a reliable sign of complete tumor embolization.
• This overflow phenomenon may contribute to controlling the portal venous supply to HCC.