Assessment of Treatment Success and Short-Term Effectiveness Using C-Arm CT Immediately after Hepatic Chemoembolization of HCC

Abstract

Background/Aims: To investigate semiquantitative analyses based on amount and morphology of iodized oil uptake about non-enhanced C-arm cone-beam CT(C-arm CT) immediately following hepatic chemoembolization of HCC. Methodology: We retrospectively reviewed 40 C-arm CT images taken immediately following chemoembolization in 29 consecutive patients who underwent hepatic chemoembolization for HCC lesions (n=97). Two radiologists scored iodized oil uptake in the index tumours from Grade 0(complete) to 4(invisible). To describe the morphologic characteristics of uptake, the lesions scored as Grade 1 to 3 were subclassified as 'defective' and 'not-defective' with respect to uptake. To evaluate the performance of this modality we performed a receiver operating characteristic curve analysis. Results: All treated lesions were classified into 'complete treatment' (n=50) and 'viable HCC(n=47). Thirty-one lesions were evaluated as Grade 0, two as Grade 4, and the rest (n=64) as between Grades 1 and 3, and the lesions of Grade 3 or 4 were all viable. Of the defective uptake lesions(n=35), 28 lesions were also viable. The areas under the curves of the lesions were 0.827 to 0.860. Conclusion: The analysis of C-arm CT based on the amount and morphologic characteristics of iodized oil uptake may be useful to predict the effectiveness of the hepatic chemoembolization of HCC.