title: Cone-Beam Computed Tomography Correlates with Conventional Helical Computed Tomography in Evaluation of Lipiodol Accumulation in HCC after Chemoembolization.
abstract: OBJECTIVE
  The amount of drug-loaded lipiodol in an HCC tumor post-transarterial chemoembolization (TACE) correlates with the risk of local tumor recurrence. Lipiodol enhancement of a tumor on conventional CT, measured in Hounsfield units (HU), can predict tumor response. Here we investigate whether cone-beam CT (CBCT) can also be used to predict tumor response, providing the benefit of being able to optimize the patient's treatment plan intra-procedurally.
  
  
  METHODS
  A total of 82 HCC nodules (82 patients), ≤5 cm in diameter, were treated with balloon-occluded TACE using miriplatin between December 2013 and November 2014. For each patient, both CBCT and conventional CT images were obtained post-TACE. The degree of correlation between CBCT and conventional CT was determined by comparing identical regions of interest for each imaging modality using pixel values.
  
  
  RESULTS
  The pixel values from conventional CT and CBCT were highly correlated, with a Pearson correlation coefficient of 0.912 (p<0.001). The location of the nodules within the liver did not affect the results; the correlation coefficient was 0.891 (p<0.001) for the left lobe and 0.926 (p<0.001) for the right lobe. The mean pixel value for conventional CT was 439 ± 279 HU, and the mean pixel value for CBCT was 416 ± 311 HU.
  
  
  CONCLUSIONS
  CBCT may be used as a substitute for conventional CT to quantitatively evaluate the amount of drug-loaded lipiodol within an HCC nodule and, hence, the efficacy of TACE treatment. The major benefit of using CBCT is the ability to predict the likelihood of local recurrence intra-procedurally, enabling subsequent treatment optimization.
authors.affiliation: Department of Gastroenterology and Hepatology, Saiseikai Niigata Daini Hospital, Niigata, Japan.
authors.forename: Toru
authors.initials: T
authors.lastname: Ishikawa
authors.affiliation: Department of Gastroenterology and Hepatology, Saiseikai Niigata Daini Hospital, Niigata, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Abe
authors.affiliation: Department of Medical Radiology, Medical Radiographer, Saiseikai Niigata Daini Hospital, Niigata, Japan.
authors.forename: Asami
authors.initials: A
authors.lastname: Hoshii
authors.affiliation: Department of Medical Radiology, Medical Radiographer, Saiseikai Niigata Daini Hospital, Niigata, Japan.
authors.forename: Yumi
authors.initials: Y
authors.lastname: Yamada
authors.affiliation: Department of Medical Radiology, Medical Radiographer, Saiseikai Niigata Daini Hospital, Niigata, Japan.
authors.forename: Akihiko
authors.initials: A
authors.lastname: Iiduka
authors.affiliation: Department of Radiology, Saiseikai Niigata Daini Hospital, Niigata, Japan.
authors.forename: Takeo
authors.initials: T
authors.lastname: Nemoto
authors.affiliation: Department of Radiology, Saiseikai Niigata Daini Hospital, Niigata, Japan.
authors.forename: Keiko
authors.initials: K
authors.lastname: Takeda
authors.affiliation: Department of Gastroenterology and Hepatology, Saiseikai Niigata Daini Hospital, Niigata, Japan.
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Yoshida
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use; D006528:Carcinoma, Hepatocellular / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000473:pathology; D016461:Chemoembolization, Therapeutic; D054893:Cone-Beam Computed Tomography; D003287:Contrast Media / Q000493:pharmacokinetics*; D004998:Ethiodized Oil / Q000493:pharmacokinetics*; D005260:Female; D006801:Humans; D008099:Liver / Q000000981:diagnostic imaging / Q000187:drug effects / Q000473:pathology; D008113:Liver Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000473:pathology; D009944:Organoplatinum Compounds / Q000627:therapeutic use; D011379:Prognosis; D012189:Retrospective Studies; D036542:Tomography, Spiral Computed; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D003287:Contrast Media; D009944:Organoplatinum Compounds; C406530:miriplatin; D004998:Ethiodized Oil