Iodized oil accumulation in hypervascular hepatocellular carcinoma after transcatheter arterial chemoembolization: comparison of imaging findings with CT during hepatic arteriography.
OBJECTIVE
To compare the degree of tumor enhancement seen on computed tomography (CT) during hepatic arteriography (CT/HA) performed before transcatheter arterial chemoembolization (TACE) versus that determined based on the accumulation of iodized oil seen on CT images obtained after TACE in patients with hypervascular hepatocellular carcinoma (HCC) and evaluate the discrepancy in findings between the two imaging modalities (more or less oil accumulation after TACE compared with enhancement on CT/HA).


METHODS
CT/HA, TACE, and iodized oil CT after TACE were performed in 69 patients with 83 hypervascular HCCs with use of an interventional CT system. The degree of contrast enhancement of the lesion on CT/HA and the iodized oil accumulation on unenhanced CT after TACE were compared.


RESULTS
Among 83 HCCs, the degree of enhancement on CT/HA before TACE corresponded to the iodized oil accumulation on CT in 56 (67.5%). Fifteen of 83 HCCs (18%) showed incomplete or poor accumulation of iodized oil despite good enhancement on CT/HA images. Twelve of 83 HCCs (14.5%) showed moderate or complete accumulation of iodized oil despite poor or no enhancement on CT/HA images. In particular, in two patients with occluded portal veins, iodized oil did not accumulate in the tumor despite good visualization on CT/HA.


CONCLUSIONS
Although iodized oil accumulation in hypervascular HCCs correlates with the degree of lesion enhancement on CT/HA in most cases, a discrepancy may occur in a substantial number of cases, which likely affects the prediction of therapeutic effects in hypervascular HCCs.
Fujita
Takeshi
T
Department of Radiology, Yamaguchi University School of Medicine, Minamikogushi, Ube, Yamaguchi, Japan. tfujita@yamaguchi-u.ac.jp
Ito
Katsuyoshi
K
Tanabe
Masahiro
M
Yamatogi
Shigenari
S
Sasai
Hideko
H
Matsunaga
Naofumi
N
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000792:Angiography; D006528:Carcinoma, Hepatocellular / Q000098:blood supply / Q000000981:diagnostic imaging* / Q000628:therapy; D016461:Chemoembolization, Therapeutic; D003287:Contrast Media; D005260:Female; D006499:Hepatic Artery / Q000000981:diagnostic imaging*; D006801:Humans; D007459:Iodized Oil; D008113:Liver Neoplasms / Q000098:blood supply / Q000000981:diagnostic imaging* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D014057:Tomography, X-Ray Computed / Q000379:methods*
D003287:Contrast Media; D007459:Iodized Oil