title: Extra-hepatic feeding arteries of hepatocellular carcinoma: An investigation based on intra-arterial CT aortography images using an angio-MDCT system.
abstract: OBJECTIVE
  We investigated the frequencies and factors associated with the presence of extra-hepatic feeding arteries (EHFAs) of hepatocellular carcinoma (HCC) using intra-arterial CT aortography images.
  
  
  METHODS
  A total of 173 patients with HCC who underwent transarterial chemoembolization (TACE) in our institution between January 2013 and March 2015 were enrolled. The types of EHFAs were evaluated by CT aortography images using an apparatus that combines multidetector-row computed tomography and angiography system. In addition, factors associated with the presence of EHFAs were determined.
  
  
  RESULTS
  EHFAs were present in 22 (12.7%) patients with HCC. EHFAs most frequently branched from the right inferior phrenic artery (n=19), while others branched from the right adrenal artery (n=2), right renal artery (n=2), right internal thoracic artery (n=2), branches of the superior mesenteric artery (n=1), and an unknown artery from the aorta (n=1). Factors significantly associated with the presence of EHFAs in multivariate analysis were tumor size≥30mm (odds ratio (OR), 5.233 [95% confidence interval (CI), 1.507-17.413]; p=0.009) and number of prior TACE treatments≥3 (OR, 6.847 [95% CI, 1.928-24.311]; p=0.003).
  
  
  CONCLUSIONS
  EHFAs of HCC were assessed with CT aortography images. Repeat TACE treatments and large tumor size were risk factors for the presence of EHFAs.
authors.affiliation: Department of Medical Technology, Ogaki Municipal Hospital, Ogaki, Japan; Graduate School of Medical Science, Kanazawa University, Kanazawa, Japan. Electronic address: takada121@gmail.com.
authors.forename: Ken
authors.initials: K
authors.lastname: Takada
authors.affiliation: Department of Gastroenterology and Hepatology, Ogaki Municipal Hospital, Ogaki, Japan. Electronic address: tahkun56@gmail.com.
authors.forename: Takanori
authors.initials: T
authors.lastname: Ito
authors.affiliation: Department of Gastroenterology and Hepatology, Ogaki Municipal Hospital, Ogaki, Japan. Electronic address: hosp3@omh.ogaki.gifu.jp.
authors.forename: Takashi
authors.initials: T
authors.lastname: Kumada
authors.affiliation: Department of Gastroenterology and Hepatology, Ogaki Municipal Hospital, Ogaki, Japan. Electronic address: hmtoyoda@spice.ocn.ne.jp.
authors.forename: Hidenori
authors.initials: H
authors.lastname: Toyoda
authors.affiliation: Department of Gastroenterology and Hepatology, Ogaki Municipal Hospital, Ogaki, Japan. Electronic address: tadat0627@gmail.com.
authors.forename: Toshifumi
authors.initials: T
authors.lastname: Tada
authors.affiliation: Department of Radiology, Ogaki Municipal Hospital, Ogaki, Japan. Electronic address: yasukun.no.mac.apple@me.com.
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Sone
authors.affiliation: Department of Medical Technology, Ogaki Municipal Hospital, Ogaki, Japan. Electronic address: housya-ct01@omh.ogaki.gifu.jp.
authors.forename: Tokio
authors.initials: T
authors.lastname: Endo
authors.affiliation: Department of Medical Technology, Ogaki Municipal Hospital, Ogaki, Japan. Electronic address: ksktanaka911@gmail.com.
authors.forename: Keisuke
authors.initials: K
authors.lastname: Tanaka
authors.affiliation: Department of Medical Technology, Ogaki Municipal Hospital, Ogaki, Japan. Electronic address: kitagawa.0406@gmail.com.
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Kitagawa
authors.affiliation: Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa, Japan. Electronic address: ichikawa@mhs.mp.kanazawa-u.ac.jp.
authors.forename: Katsuhiro
authors.initials: K
authors.lastname: Ichikawa
mesh_terms: D000311:Adrenal Glands / Q000098:blood supply / Q000000981:diagnostic imaging; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001027:Aortography / Q000379:methods*; D006528:Carcinoma, Hepatocellular / Q000098:blood supply* / Q000000981:diagnostic imaging; D016461:Chemoembolization, Therapeutic / Q000379:methods; D000072226:Computed Tomography Angiography / Q000379:methods*; D003287:Contrast Media; D003964:Diaphragm / Q000098:blood supply / Q000000981:diagnostic imaging; D005260:Female; D006499:Hepatic Artery / Q000000981:diagnostic imaging; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods; D007479:Iopamidol; D008113:Liver Neoplasms / Q000098:blood supply* / Q000000981:diagnostic imaging; D008297:Male; D017538:Mesenteric Artery, Superior / Q000000981:diagnostic imaging; D008875:Middle Aged; D061330:Multidetector Computed Tomography / Q000379:methods*; D009389:Neovascularization, Pathologic / Q000000981:diagnostic imaging*; D012077:Renal Artery / Q000000981:diagnostic imaging; D013895:Thoracic Arteries / Q000000981:diagnostic imaging; D047368:Tumor Burden
chemical_list: D003287:Contrast Media; D007479:Iopamidol
keywords: Angiography; Extra-hepatic feeding arteries; Hepatocellular carcinoma (HCC); Multi detector-row computed tomography (MDCT); Transarterial chemoembolization (TACE)