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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
PubMed
Summary
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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.

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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.