title: Hepatocellular carcinoma in the caudate lobe of the liver: angiographic analysis of tumor-feeding arteries according to subsegmental location.
abstract: OBJECTIVE
  To investigate the tumor-feeding arteries in hepatocellular carcinoma (HCC) arising in the caudate lobe of the liver.
  
  
  METHODS
  From January 1998 to March 2004, 140 patients with 146 caudate HCCs underwent chemoembolization. Subsegmental location of the caudate HCC and the origin of the tumor-feeding arteries was determined with computed tomography and hepatic arteriography. On follow-up angiography at 6-96 months (mean, 24 months), changes in the tumor-feeding arteries were recorded.
  
  
  RESULTS
  A total of 175 tumor-feeding arteries were identified. The tumors in the Spiegel lobe (n = 72) were supplied by tumor-feeding arteries derived from the right hepatic artery (RHA; n = 45), left hepatic artery (LHA; n = 30), and proper hepatic artery (PHA) or common hepatic artery (CHA; n = 6; P = .083, right vs left). In tumors in the paracaval portion (n = 42), the tumor-feeding arteries were derived more frequently from the RHA (n = 46) than the LHA (n = 3) or PHA/CHA (n = 2; P < .001). All the feeding arteries (n = 43) of the caudate process tumors (n = 32) were derived from the RHA (P < .001). During the follow-up period, there were replacements of the tumor-feeding arteries in 16 patients with recurrent tumors. An extrahepatic collateral supply for the recurrent tumors developed in 10 patients.
  
  
  CONCLUSIONS
  The distribution of the origin of tumor-feeding arteries supplying caudate HCC is different according to tumors' subsegmental locations. When treating recurrent caudate HCC, it is important to identify replacement of tumor-feeding arteries and extrahepatic collateral supply.
authors.affiliation: Department of Radiology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seoul, Korea.
authors.forename: Chang Jin
authors.initials: CJ
authors.lastname: Yoon
authors.forename: Jin Wook
authors.initials: JW
authors.lastname: Chung
authors.forename: Baik Hwan
authors.initials: BH
authors.lastname: Cho
authors.forename: Hwan Jun
authors.initials: HJ
authors.lastname: Jae
authors.forename: Sung-Gwon
authors.initials: SG
authors.lastname: Kang
authors.forename: Hyo-Cheol
authors.initials: HC
authors.lastname: Kim
authors.forename: Young Ho
authors.initials: YH
authors.lastname: Choi
authors.forename: Ung Bae
authors.initials: UB
authors.lastname: Jeon
authors.forename: Jae Hyung
authors.initials: JH
authors.lastname: Park