title: Assessment of Lipiodol Deposition and Residual Cancer for Hepatocellular Carcinoma After Transcatheter Arterial Chemoembolization via Iodine-Based Material Decomposition Images with Spectral Computed Tomography Imaging: A Preliminary Study.
abstract: BACKGROUND
  It is critical to follow up hepatocellular carcinoma (HCC) after transcatheter arterial chemoembolization (TACE) in clinical practice. Computed tomography (CT) is used to assess lipiodol deposition, whereas it is difficult to assess hypovascular residual cancer masked by lipiodol. In contrast, magnetic resonance imaging (MRI) is superior to CT in showing residual cancer, but cannot display lipiodol deposition.
  
  
  OBJECTIVE
  The aim of this study was to investigate the value of spectral CT imaging in both lipiodol deposition and residual cancer for HCC patients after TACE.
  
  
  METHODS
  Ten HCC patients after treated with TACE underwent Discovery CT750 HD and MRI750 3T examination. Receiver operating characteristic (ROC) curves of iodine-based material decomposition images, monochromatic images and conventional CT images were generated.
  
  
  RESULTS
  Consequently, 30 residual lesions were detected in MRI of 10 patients. They were found in iodine-based images and monochromatic images versus 29 in conventional CT images. The area under ROC curves for the lesion-to-normal parenchyma ratio (LNR) on arterial phase (AP) in iodine-based material decomposition images, monochromatic images and conventional CT images were 0.933, 0.833 and 0.817, respectively.
  
  
  CONCLUSIONS
  The study data highlighted good value of iodine-based material decomposition images of spectral CT in assessment of both lipiodol deposition and residual cancer for follow-up of HCC patients previously treated with TACE.
authors.affiliation: Department of Radiology, Shanghai First People's Hospital, School of Medicine, Jiao Tong University, Shanghai, China.
authors.forename: Yanhong
authors.initials: Y
authors.lastname: Xu
authors.affiliation: Department of Interventional Radiology, Shanghai First People's Hospital, School of Medicine, Jiao Tong University, Shanghai, China.
authors.forename: An
authors.initials: A
authors.lastname: Xiao
authors.affiliation: Department of Radiology, Shanghai First People's Hospital, School of Medicine, Jiao Tong University, Shanghai, China.
authors.forename: Jia
authors.initials: J
authors.lastname: Yang
authors.affiliation: Department of Radiology, Shanghai First People's Hospital, School of Medicine, Jiao Tong University, Shanghai, China.
authors.forename: Zaixian
authors.initials: Z
authors.lastname: Zhang
authors.affiliation: Department of Radiology, Shanghai First People's Hospital, School of Medicine, Jiao Tong University, Shanghai, China.
authors.forename: Guixiang
authors.initials: G
authors.lastname: Zhang
keywords: Carcinoma; Hepatocellular; Magnetic Resonance Imaging; Tomography