The usefulness of cone-beam computed tomography during chemoembolization of hepatocellular carcinomas fed exclusively by the cystic artery.

PURPOSE: To evaluate the usefulness of cone-beam computed tomography (CBCT) for monitoring the transcatheter arterial chemoembolization (TACE) of hepatocellular carcinomas supplied by the cystic artery.

MATERIALS AND METHODS: In seven tumors (mean diameter: 19 mm), the iodized oil distributions in the tumor and gallbladder wall were evaluated by CBCT after injecting iodized oil emulsion (LipCBCT) through the cystic artery. Gelatin sponge particles were injected to completely obstruct the tumor-feeding vessel when iodized oil deposition was seen in less than one third of the wall circumference. The following parameters were retrospectively investigated: (1) the iodized oil distribution during LipCBCT and on CT scans 1 week after TACE; (2) local tumor control; and (3) complications.

RESULTS: LipCBCT showed iodized oil accumulation throughout the entire tumor in all cases, and iodized oil deposition in the gallbladder wall in three cases (43 %) (less than one third of the circumference). Therefore, gelatin sponge particles were used in all cases. CT 1 week after TACE showed an almost identical iodized oil distribution to intraoperative LipCBCT. None of the tumors recurred during follow-up, and no complications occurred.

CONCLUSION: CBCT is useful for evaluating the distribution of iodized oil in TACE via the cystic artery.