title: Multidetector computed tomography angiography in the management of transarterial embolization of primary and secondary liver malignancy.
abstract: BACKGROUND
  Endovascular management is the mainstay of therapy for most patients with primary and secondary liver tumors. Radiologist should understand the anatomy of the hepatic vasculature and tumor feeding vessels to ensure successful conduction of the embolization procedure. The aim of this study was to evaluate the accuracy of multidetector computed tomographic angiography (MDCTA) for the evaluation of hepatic arterial anatomy and tumor feeding vessels prior to embolization procedure.
  
  
  METHODS
  This study included 42 patients. They were 30 with hepatocellular carcinoma, 6 with colorectal cancer metastases, 3 with intrahepatic cholangiocellular carcinoma, 2 with giant focal nodular hyperplasia and 1 with gallbladder tumor. The findings of MDCTA were compared with the DSA findings, which served as the standard of reference. Sensitivity and specificity of the MDCTA were calculated.
  
  
  RESULTS
  MDCTA showed 100% coincidence with the DSA and 100% accuracy in the evaluation of gross hepatic arterial anatomy and its variations. 61 out of the 64 feeders were correctly identified with the MDCTA. False positives and false negatives were 3 each. Accordingly sensitivity and specificity were 95.31%, 97.95% respectively.
  
  
  CONCLUSIONS
  MDCT angiography permits accurate assessment of the hepatic vascular anatomy. Although some pathways of tumor irrigation may not be well visible on the computed tomography. These require detailed reevaluation of suspected tumor feeders during embolization procedure.
authors.affiliation: Department of Radiology, Tbilisi State Medical University, Tbilisi, Georgia - nikaonashvili@mail.ru.
authors.forename: Nikoloz
authors.initials: N
authors.lastname: Onashvili
authors.forename: Malkhaz
authors.initials: M
authors.lastname: Mizandari
authors.forename: Tamta
authors.initials: T
authors.lastname: Azrumelashvili
authors.forename: Ana
authors.initials: A
authors.lastname: Ingorokva
authors.forename: Giorgi
authors.initials: G
authors.lastname: Ubiria
mesh_terms: D000792:Angiography / Q000379:methods; D001650:Bile Duct Neoplasms / Q000628:therapy; D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging / Q000556:secondary / Q000628:therapy*; D018281:Cholangiocarcinoma / Q000000981:diagnostic imaging / Q000556:secondary / Q000628:therapy*; D015179:Colorectal Neoplasms / Q000000981:diagnostic imaging / Q000556:secondary / Q000628:therapy*; D004621:Embolization, Therapeutic / Q000379:methods; D005260:Female; D020518:Focal Nodular Hyperplasia / Q000000981:diagnostic imaging / Q000628:therapy; D005706:Gallbladder Neoplasms / Q000000981:diagnostic imaging / Q000556:secondary / Q000628:therapy*; D006499:Hepatic Artery; D006801:Humans; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography; D011237:Predictive Value of Tests; D011857:Radiographic Image Interpretation, Computer-Assisted; D011877:Radionuclide Imaging; D012680:Sensitivity and Specificity; D016896:Treatment Outcome