[The role of cone-beam CT during transarterial chemoembolization for liver cancer]
Péter Tamáska1, Gergely Ráski1, Ákos Pataki1
1Klinikai és Intervenciós Radiológiai Centrum, Intervenciós Radiológiai Osztály, Borsod-Abaúj-Zemplén Megyei Kórház és Egyetemi Oktató Kórház 3501 Miskolc, Szentpéteri kapu 72-76.
Purpose:
The role of interventional radiology in the treatment of hepatic malignancies is steeply raising. Our purpose is to present the importance of cone-beam CT (CBCT) during TACE (transarterial chemoembolization) procedures for liver tumours.
Patients And Methods:
Between 1st of June 2013 and 31st of July 2016, we performed 130 TACE procedures in 64 patients in the Borsod University Teaching Hospital at Miskolc. During some of the treatments of 44 patients CBCT was also performed.
Results:
All procedures were successful and carried out safely. CBCT gave new information in 22,7%, that influenced further treatment. It helped to precisely localize tumours, corrected the number or the size of hepatic malignancies. With CBCT it was easier to identify the feeding arteries of the tumour, plan the actual treatment and also to assess the efficacy of the previous treatment.
Discussion:
The gold standard therapy of intermediate-stage HCC (according to Barcelona's criteria) is TACE. Beside, it can be safely and efficiently performed also in early stage or advanced stage in cases of contraindications for alternative therapies. Cone-beam CT is a dynamic examination which gives you an intraoperative, 3D CT-like imaging in the angio suit, without moving the table or the catheterised patient. Literature has already cited preliminary datas about prolonged survival for those patients treated with the help of CBCT intraoperatively.
Conclusion:
Intraoperative CBCT in patients with TACE treatment for hepatic malignancies can provide information that can improve the therapeutic results. Therefore we suggest the routine use of this imaging option during all TACE procedures if patients are eligible.
