Transcatheter arterial chemoembolization for hepatocellular carcinoma: prospective assessment of the right inferior phrenic artery with C-arm CT.
OBJECTIVE
To assess the usefulness of C-arm computed tomography (CT) of the right inferior phrenic artery (RIPA) in transcatheter arterial chemoembolization of patients with hepatocellular carcinoma (HCC).


METHODS
From December 2007 to April 2008, C-arm CT of the RIPA was prospectively performed in 32 patients with HCC. Two interventional radiologists who performed C-arm CT assessed the additional information provided with C-arm CT as grade 1 (no additional information), grade 2 (added information without an effect on the treatment plan), or grade 3 (added information with an effect on the treatment plan). Tumor feeders and feeders of a systemic-to-pulmonary shunt were recorded.


RESULTS
The information provided by C-arm CT was classified as grade 1 for nine of the 32 patients (28%), grade 2 for 20 patients (63%), and grade 3 for three patients (9%). The most common additional information from C-arm CT scans of the RIPA was the differentiation between the tumor and the systemic-to-pulmonary shunt. A systemic-to-pulmonary shunt from the RIPA was observed in 22 patients (69%), and the most common feeder of a systemic-to-pulmonary shunt was the azygoesophageal branch.


CONCLUSIONS
C-arm CT of the RIPA provides additional imaging information for the differentiation of a tumor from a nontumorous condition during chemoembolization for HCC with a suspected blood supply from an RIPA.
Kim
Hyo-Cheol
HC
Department of Radiology, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, 110-744, Korea.
Chung
Jin Wook
JW
Park
Jae Hyung
JH
An
Sangbu
S
Son
Kyu Ri
KR
Seong
Nak Jong
NJ
Jae
Hwan Jun
HJ
D000368:Aged; D000369:Aged, 80 and over; D000903:Antibiotics, Antineoplastic / Q000008:administration & dosage; D006528:Carcinoma, Hepatocellular / Q000098:blood supply* / Q000000981:diagnostic imaging / Q000628:therapy*; D002406:Catheterization, Peripheral / Q000379:methods; D016461:Chemoembolization, Therapeutic / Q000379:methods*; D004317:Doxorubicin / Q000008:administration & dosage*; D005260:Female; D005781:Gelatin Sponge, Absorbable / Q000008:administration & dosage; D006490:Hemostatics / Q000008:administration & dosage; D006801:Humans; D007261:Infusions, Intra-Arterial / Q000379:methods; D008113:Liver Neoplasms / Q000098:blood supply* / Q000000981:diagnostic imaging / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D015641:Radiography, Interventional / Q000379:methods; D014057:Tomography, X-Ray Computed / Q000379:methods*; D016896:Treatment Outcome
D000903:Antibiotics, Antineoplastic; D006490:Hemostatics; D004317:Doxorubicin