title: Arterial portography during transarterial chemoembolization: still a necessity in the age of contrast-enhanced cross-sectional imaging?
abstract: OBJECTIVE
  To evaluate the necessity of arterial portography (AP) if a patent portal vein is seen on imaging before transarterial chemoembolization.
  
  
  METHODS
  All patients who underwent transarterial chemoembolization between January 2004 and July 2011 were retrospectively recruited. The study included 131 patients (100 men, 31 women) undergoing 243 transarterial chemoembolization procedures. AP was performed during 93 procedures. The mean time interval between imaging performed before transarterial chemoembolization and the transarterial chemoembolization procedure was 46.5 days (range, 0-161 d).
  
  
  RESULTS
  AP did not detect any new cases of portal vein thrombosis (PVT) when imaging performed transarterial chemoembolization showed a patent portal vein. Imaging performed after transarterial chemoembolization revealed one main PVT, one left PVT extending into the main portal vein, two left PVT, and one right PVT. When imaging performed before transarterial chemoembolization showed a patent portal vein and AP was omitted, imaging performed after transarterial chemoembolization showed one case of main PVT, two right PVT, and two left PVT. In both groups, there was no significant difference in mortality (P = .673) or morbidity (P = .581) related to transarterial chemoembolization.
  
  
  CONCLUSIONS
  AP is unnecessary if transarterial chemoembolization is performed within a reasonable time frame following computed tomography or magnetic resonance imaging that showed a patent portal vein. Omitting AP potentially reduces contrast material and radiation burden to both the patient and the operator.
authors.affiliation: Department of Diagnostic Radiology, Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng, Singapore 308433. Electronic address: terrencehui123@gmail.com.
authors.forename: Terrence C H
authors.initials: TC
authors.lastname: Hui
authors.affiliation: Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
authors.forename: Uei
authors.initials: U
authors.lastname: Pua
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D016461:Chemoembolization, Therapeutic / Q000009:adverse effects / Q000401:mortality; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography; D011169:Portal Vein / Q000000981:diagnostic imaging* / Q000503:physiopathology; D011172:Portography; D011237:Predictive Value of Tests; D011829:Radiation Dosage; D015641:Radiography, Interventional; D012189:Retrospective Studies; D013997:Time Factors; D061665:Time-to-Treatment; D016896:Treatment Outcome; D019564:Unnecessary Procedures; D014654:Vascular Patency; D020246:Venous Thrombosis / Q000000981:diagnostic imaging* / Q000401:mortality / Q000503:physiopathology
keywords: AP; HCC; PVT; arterial portography; hepatocellular carcinoma; portal vein thrombosis