title: Evaluation of hepatocellular carcinoma supplied by the right inferior phrenic artery at initial treatment.
abstract: OBJECTIVE
  Recurrent hepatocellular carcinoma (HCC) often occurs with extrahepatic supply because of various factors. The right inferior phrenic artery (RIPA) is the most frequent extrahepatic feeding artery, however, it is rarely found that the RIPA supplies the tumor in patients with HCC at initial treatment. The purpose of this study is to evaluate the radiological findings of untreated cases of HCC fed by the RIPA.
  
  
  METHODS
  Medical records, computed tomography scans, and angiograms in 14 patients with HCC fed by the RIPA at initial therapy were reviewed. We evaluated growth pattern, size, location of tumors, and patency of the hepatic artery.
  
  
  RESULTS
  In all cases, tumors showed exophytic growth. Eleven cases (79%) were massive type. Tumor size ranged from 4.5 cm to 16.8 cm (mean, 11.1 cm). In 11 cases (79%), tumors were mainly located in liver segment 7. The patency of the hepatic arteries was intact in all cases.
  
  
  CONCLUSIONS
  Regardless of initial therapy, HCC with exophytic growth pattern, especially located in the hepatic areas directly beneath the diaphragm and of massive type, can be supplied by the RIPA.
authors.affiliation: Department of Radiology, Division of Medical Intelligence and Informatics, Graduate School of Biomedical Science, Hiroshima University, Hiroshima, Japan. hieda@hiroshima-u.ac.jp
authors.forename: Masashi
authors.initials: M
authors.lastname: Hieda
authors.forename: Naoyuki
authors.initials: N
authors.lastname: Toyota
authors.forename: Hideaki
authors.initials: H
authors.lastname: Kakizawa
authors.forename: Nobuhiko
authors.initials: N
authors.lastname: Hirai
authors.forename: Toshihiro
authors.initials: T
authors.lastname: Tachikake
authors.forename: Noriaki
authors.initials: N
authors.lastname: Matsuura
authors.forename: Masaki
authors.initials: M
authors.lastname: Ishikawa
authors.forename: Katsuhide
authors.initials: K
authors.lastname: Ito
mesh_terms: D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging* / Q000628:therapy*; D016461:Chemoembolization, Therapeutic / Q000379:methods*; D005260:Female; D006801:Humans; D008099:Liver / Q000098:blood supply* / Q000000981:diagnostic imaging*; D008113:Liver Neoplasms / Q000000981:diagnostic imaging* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009389:Neovascularization, Pathologic / Q000000981:diagnostic imaging* / Q000628:therapy*; D011379:Prognosis; D011859:Radiography; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D016896:Treatment Outcome