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CT findings after hepatic chemoembolization.
T J Meakem1, E C Unger, G D Pond
1Department of Radiology, University of Arizona Health Sciences Center, Tucson 85724.
Journal of Computer Assisted Tomography
|November 1, 1992
Summary
Hepatic arterial chemoembolization (CE) effectively treats colorectal cancer liver metastases by inducing tumor necrosis. Follow-up CT scans show initial necrosis, potential ischemia, and eventual disease recurrence after CE therapy.
Area of Science:
- Interventional Radiology
- Oncology
- Diagnostic Imaging
Background:
- Colorectal carcinoma frequently metastasizes to the liver.
- Hepatic arterial chemoembolization (CE) is an option for treating liver metastases.
Purpose of the Study:
- To describe the sequential changes on liver CT scans after hepatic arterial chemoembolization (CE) for colorectal cancer metastases.
- To correlate CT findings with tumor response and patient outcomes.
Main Methods:
- Retrospective review of 30 CT scans from 7 patients undergoing 11 CE procedures.
- Baseline, immediate post-procedural, and follow-up CT scans at 1-2 month intervals.
- Correlation of CT findings with carcinoembryonic antigen (CEA) levels.
Main Results:
- Immediate scans mapped embolization; some lesions became isodense.
- Early follow-up showed tumor necrosis (confirmed by decreased CEA) and potential ischemia/infarction.
- Intermediate follow-up (2-3 months) showed >=25% tumor volume decrease in 71% of patients.
- Late follow-up revealed disease recurrence and new lesions in all patients.
Conclusions:
- Hepatic arterial chemoembolization induces tumor necrosis and can cause ischemia.
- Maximal tumor volume reduction is observed at 2-3 months post-CE.
- Recurrence is common, necessitating ongoing surveillance.