title: Noncontrast chest computed tomography immediately after transarterial chemoembolization in patients with hepatocellular carcinoma: clinical benefits and effect of radiation reduction on image quality in low-dose scanning.
abstract: OBJECTIVE
  To evaluate the clinical benefits of noncontrast chest computed tomography (CT) immediately after transarterial chemoembolization in patients with hepatocellular carcinoma and to assess the effect of radiation reduction on image quality in low-dose scanning.
  
  
  METHODS
  From June to October 2010, we performed standard-dose, noncontrast chest CTs immediately after transarterial chemoembolization in 160 patients and low-dose CTs in 88 patients. We reviewed the entire noncontrast chest CTs and follow-up CTs to reveal the clinical benefits of CT evaluation immediately after transarterial chemoembolization. Using two independent readers, we also retrospectively evaluated the radiation dose and image quality in terms of the image noise, contrast between the liver parenchyma and iodized oil and diagnostic acceptability for the evaluation of treatment response after transarterial chemoembolization.
  
  
  RESULTS
  In 5.2% of the patients, additional treatment was performed immediately after the interpretation of the noncontrast chest CT, and additional pulmonary lesions were found in 8.5% of the patients. The measured mean dose-length product for the low-dose scanning was 18.4% of that of the standard-dose scanning. The image noise was significantly higher with the low-dose scanning (p<0.001). However, all of the low-dose CT scans were diagnostically acceptable, and the mean scores for the subjective assessments of the contrast and diagnostic acceptability showed no significant differences for either reader.
  
  
  CONCLUSIONS
  A noncontrast chest CT immediately after transarterial chemoembolization has some clinical benefits for immediate decision making and detecting pulmonary lesions. Low-dose, noncontrast chest CTs immediately after transarterial chemoembolization consistently provide diagnostically acceptable images and information on treatment response in patients who have undergone transarterial chemoembolization.
authors.affiliation: Center for Liver Cancer, Research Institute and Hospital, National Cancer Center, Goyang-si, Republic of Korea.
authors.forename: Joon-Il
authors.initials: JI
authors.lastname: Choi
authors.forename: Hyun Beom
authors.initials: HB
authors.lastname: Kim
authors.forename: Min Ju
authors.initials: MJ
authors.lastname: Kim
authors.forename: Jong Seok
authors.initials: JS
authors.lastname: Lee
authors.forename: Young Whan
authors.initials: YW
authors.lastname: Koh
authors.forename: Sang Bu
authors.initials: SB
authors.lastname: An
authors.forename: Heung-kyu
authors.initials: HK
authors.lastname: Ko
authors.forename: Joong-Won
authors.initials: JW
authors.lastname: Park
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging* / Q000601:surgery / Q000628:therapy*; D017115:Catheter Ablation / Q000379:methods; D016461:Chemoembolization, Therapeutic; D005260:Female; D006801:Humans; D007459:Iodized Oil / Q000008:administration & dosage; D008113:Liver Neoplasms / Q000000981:diagnostic imaging* / Q000601:surgery / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011829:Radiation Dosage; D015641:Radiography, Interventional / Q000379:methods*; D013902:Radiography, Thoracic / Q000379:methods*; D014057:Tomography, X-Ray Computed / Q000379:methods*; D016896:Treatment Outcome
chemical_list: D007459:Iodized Oil