title: Objective Measurement of Arterial Flow Before and After Transcatheter Arterial Chemoembolization: A Feasibility Study Using Quantitative Color-Coding Analysis.
abstract: OBJECTIVE
  To quantitatively measure the hemodynamic change of hepatic artery before and after transcatheter arterial chemoembolization (TACE) of hepatocellular carcinoma (HCC) by quantitative color-coding analysis (QCA).
  
  
  METHODS
  This prospective study registered 64 consecutive HCC patients who underwent segmental or subsegmental TACE with epirubicin and lipiodol at level 2 or 3 of the subjective angiographic chemoembolization endpoint. QCA was used to determine the maximal density time (T(max)) of selected intravascular region of interest (ROI). Relative T(max) (rT(max)) was defined as the T(max) at the selected ROI minus the time of contrast medium spurting from the catheter tip. The rT(max) of hepatic arteries was analyzed before and after embolization.
  
  
  RESULTS
  The pre- and post-treatment rT(max) of the landmarks at the treated segmental artery were 1.96 ± 0.48 and 3.14 ± 1.77 s, p < 0.001. According to the treated lobe, 30 patients were treated for the right lobe alone, and 8 patients were treated for the left lobe alone. The pre- and post-rT(max) of treated segmental artery were 2.06 ± 0.54, 3.34 ± 1.63 s, p < 0.001 and 1.89 ± 0.45, 2.68 ± 1.46 s, p = 0.12, respectively. The rT(max) of the proximal lobar hepatic arteries or proper hepatic artery had no significant change before and after TACE.
  
  
  CONCLUSIONS
  The QCA is feasible to quantify embolization endpoints by comparing the rT(max) in selected hepatic arteries before and after TACE. The rT(max) of treated segmental artery was significant prolonged after optimized procedures.
authors.affiliation: Department of Radiology, Taipei Veterans General Hospital, No. 201, Sec. 2, Shipai Rd., Beitou District, Taipei, Taiwan. dryylin@gmail.com.|School of Medicine, National Yang Ming University, No. 155, Sec. 2, Linong Street, Taipei, 112, Taiwan. dryylin@gmail.com.|Institute of Clinical Medicine, National Yang-Ming University, No. 155, Sec. 2, Linong Street, Taipei, 112, Taiwan. dryylin@gmail.com.
authors.forename: Yi-Yang
authors.initials: YY
authors.lastname: Lin
authors.affiliation: Department of Radiology, Taipei Veterans General Hospital, No. 201, Sec. 2, Shipai Rd., Beitou District, Taipei, Taiwan. rclee@vghtpe.gov.tw.|School of Medicine, National Yang Ming University, No. 155, Sec. 2, Linong Street, Taipei, 112, Taiwan. rclee@vghtpe.gov.tw.
authors.forename: Rheun-Chuan
authors.initials: RC
authors.lastname: Lee
authors.affiliation: Department of Radiology, Taipei Veterans General Hospital, No. 201, Sec. 2, Shipai Rd., Beitou District, Taipei, Taiwan. hstseng@vghtpe.gov.tw.|School of Medicine, National Yang Ming University, No. 155, Sec. 2, Linong Street, Taipei, 112, Taiwan. hstseng@vghtpe.gov.tw.
authors.forename: Hsiuo-Shan
authors.initials: HS
authors.lastname: Tseng
authors.affiliation: Department of Radiology, Taipei Veterans General Hospital, No. 201, Sec. 2, Shipai Rd., Beitou District, Taipei, Taiwan. terryliu0264@gmail.com.|School of Medicine, National Yang Ming University, No. 155, Sec. 2, Linong Street, Taipei, 112, Taiwan. terryliu0264@gmail.com.
authors.forename: Chien-An
authors.initials: CA
authors.lastname: Liu
authors.affiliation: Department of Radiology, Taipei Veterans General Hospital, No. 201, Sec. 2, Shipai Rd., Beitou District, Taipei, Taiwan. wyguo@vghtpe.gov.tw.|School of Medicine, National Yang Ming University, No. 155, Sec. 2, Linong Street, Taipei, 112, Taiwan. wyguo@vghtpe.gov.tw.
authors.forename: Wan-Yuo
authors.initials: WY
authors.lastname: Guo
authors.affiliation: Department of Radiology, Taipei Veterans General Hospital, No. 201, Sec. 2, Shipai Rd., Beitou District, Taipei, Taiwan. cmychang@vghtpe.gov.tw.|School of Medicine, National Yang Ming University, No. 155, Sec. 2, Linong Street, Taipei, 112, Taiwan. cmychang@vghtpe.gov.tw.
authors.forename: Cheng-Yen
authors.initials: CY
authors.lastname: Chang
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015901:Angiography, Digital Subtraction; D000903:Antibiotics, Antineoplastic / Q000008:administration & dosage; D000970:Antineoplastic Agents / Q000008:administration & dosage; D001783:Blood Flow Velocity; D006528:Carcinoma, Hepatocellular / Q000628:therapy*; D016461:Chemoembolization, Therapeutic; D015251:Epirubicin / Q000008:administration & dosage; D004998:Ethiodized Oil / Q000008:administration & dosage; D005240:Feasibility Studies; D005260:Female; D006499:Hepatic Artery / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods*; D008113:Liver Neoplasms / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012039:Regional Blood Flow; D016896:Treatment Outcome
chemical_list: D000903:Antibiotics, Antineoplastic; D000970:Antineoplastic Agents; D015251:Epirubicin; D004998:Ethiodized Oil
keywords: Chemoembolization/chemoembolisation; Hepatocellular carcinoma (HCC); Interventional oncology; Liver/hepatic; Transarterial chemoembolization/embolisation (TACE)