title: Hepatoma feeding arteriogram created by CT during aortography using IVR 64-multidetector-row CT for catheterization in transcatheter arterial chemoembolization for hepatocellular carcinoma.
abstract: CT during aortography (CTAo) using IVR 64-multidetector-row CT (IVR-64MDCT) enables the rapid and simultaneous depiction of both the hepatic and extrahepatic feeding arteries in hepatocellular carcinoma (HCC), and can be achieved using a reasonable volume of contrast medium. The scan time is approximately 6 s from the diaphragm to the kidney using CTAo with 64MDCT with a slice thickness and slice interval of 0.5 mm. The hepatoma feeding arteriogram appears in the angiographic monitor after CTAo, and can then be used to guide catheterization. We introduce the process for creating a hepatoma feeding arteriogram, synthesized from the following three volume-rendered images: background bone, aorta to hepatic-branch artery, and hepatoma to feeding artery. Uniquely, the hepatoma feeding arteriogram enables investigation of the feeding artery from the tumor side, rather than from the aorta side, and appears superior to selective arteriography in terms of detecting small HCC and its accompanying fine feeding arteries. Identification of these arteries by CT angiography with intravenous contrast medium injection is difficult because of the similarity in CT values between the feeding artery and the surrounding liver, thereby preventing the creation of a hepatoma feeding arteriogram. CTAo accelerates the process of deciding upon the catheter treatment strategy, shifting the decision to the point at which the feeding artery is investigated, because the hepatoma feeding arteriogram enables instant identification of the feeding artery and its connection to the hepatic branch artery. CTAo with IVR-64MDCT can potentially contribute to remarkable advances in IVR, especially transcatheter arterial chemoembolization for HCC.
authors: Department of Radiology, Wakayama Medical University, 811-1 Kimiidera, Wakayama, Wakayama 641-8510, Japan.
authors: Hiroki
authors: H
authors: Minamiguchi
authors: Nobuyuki
authors: N
authors: Kawai
authors: Morio
authors: M
authors: Sato
authors: Akira
authors: A
authors: Ikoma
authors: Hiroki
authors: H
authors: Sanda
authors: Kouhei
authors: K
authors: Nakata
authors: Fumihiro
authors: F
authors: Tanaka
authors: Motoki
authors: M
authors: Nakai
authors: Tetsuo
authors: T
authors: Sonomura
authors: Kazuhiro
authors: K
authors: Murotani
authors: Seiki
authors: S
authors: Hosokawa
authors: Tadayoshi
authors: T
authors: Nishioku
mesh_terms: D000792:Angiography / Q000379:methods; D000970:Antineoplastic Agents / Q000008:administration & dosage; D001027:Aortography; D006528:Carcinoma, Hepatocellular / Q000098:blood supply / Q000000981:diagnostic imaging* / Q000628:therapy*; D002404:Catheterization / Q000379:methods; D016461:Chemoembolization, Therapeutic / Q000295:instrumentation / Q000379:methods; D003287:Contrast Media; D006499:Hepatic Artery / Q000000981:diagnostic imaging; D006801:Humans; D008113:Liver Neoplasms / Q000098:blood supply / Q000000981:diagnostic imaging* / Q000628:therapy*; D061330:Multidetector Computed Tomography / Q000379:methods; D011237:Predictive Value of Tests; D015641:Radiography, Interventional / Q000379:methods; D012680:Sensitivity and Specificity; D013813:Therapy, Computer-Assisted / Q000379:methods; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D003287:Contrast Media
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