Therapeutic effect of percutaneous ethanol injection on small hepatocellular carcinoma: evaluation with CT.
OBJECTIVE
To evaluate the therapeutic effect of percutaneous ethanol injection (PEI) on small hepatocellular carcinoma (HCC) with computed tomography (CT).


METHODS
Sixty-seven patients with histologically proved HCC 3 cm or less in diameter underwent PEI. The patients were regularly followed up with sonography and contrast material-enhanced CT for more than 1 year (range, 12-96 months). The CT findings were evaluated for three tumor types distinguished on the basis of their appearance relative to that of the surrounding liver parenchyma: type 1 = hyperattenuating at the early phase (n = 39), type 2 = iso- or hypoattenuating at the early phase and hypoattenuating at the late phase (n = 18), and type 3 = isoattenuating (not detected) at both the early and late phases (n = 10).


RESULTS
After PEI, a necrotic area of HCC and the surrounding liver parenchyma was characterized as hypoattenuating at both early and late phases of contrast-enhanced CT, regardless of the type. When an HCC appeared to be completely necrotic within 3 months after PEI, this status was retained until the latest observation in all but three cases.


CONCLUSIONS
Contrast-enhanced CT can correctly depict PEI-induced necrosis in HCC and is reliable for evaluating the therapeutic effect of PEI.
Ebara
M
M
First Department of Medicine, School of Medicine, Chiba University, Japan.
Kita
K
K
Sugiura
N
N
Yoshikawa
M
M
Fukuda
H
H
Ohto
M
M
Kondo
F
F
Kondo
Y
Y
D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging / Q000401:mortality / Q000628:therapy*; D003974:Diatrizoate Meglumine; D000431:Ethanol / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007479:Iopamidol; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000401:mortality / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011677:Punctures; D015996:Survival Rate; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D000509:alpha-Fetoproteins / Q000032:analysis
D000509:alpha-Fetoproteins; D000431:Ethanol; D003974:Diatrizoate Meglumine; D007479:Iopamidol