Chemoembolization via the left internal mammary artery supplying hepatocellular carcinoma

To present radiologic findings that show favorable tumor response after chemoembolization via the left internal mammary artery (LIMA).

Between October 2002 and April 2013, 57 patients with hepatocellular carcinoma (HCC) underwent 69 sessions of chemoembolization via the LIMA. Imaging findings including tumor size, location, and visibility of tumor-feeding artery on cross-sectional images were retrospectively reviewed in consensus by two radiologists. Tumor response after chemoembolization via the LIMA was assessed by the modified Response Evaluation Criteria in Solid Tumors on follow-up multidetector computed tomography in consensus.

The mean tumor size supplied by the LIMA was 6.8 cm (range, 1.0-21.0 cm). HCCs supplied by the LIMA tended to be located in the subcapsular area including exophytic features (57 of 57; 100%) and were more likely to be located in the left lobe of the liver (56 of 57; 98%). HCCs supplied by the LIMA were more likely to be multiple or infiltrative (52 of 57; 91%) and marginally recurred (43 of 57; 75%). Feeding arteries of the LIMA were identified in a high percentage of cases (49 of 66; 74%) on cross-sectional images obtained before embolization. Regarding tumor response, tumors that were newly developed or exclusively supplied by the LIMA showed better target tumor response (P = .011 and P < .0001, respectively). On multivariate analysis, tumors exclusively supplied by the LIMA showed significantly better target tumor response with odds ratio of 16.32.

Chemoembolization via the LIMA has a favorable target tumor response when HCCs are exclusively supplied by the LIMA.