Skip to main content
Erschienen in: CardioVascular and Interventional Radiology 6/2015

01.12.2015 | Clinical Investigation

Objective Measurement of Arterial Flow Before and After Transcatheter Arterial Chemoembolization: A Feasibility Study Using Quantitative Color-Coding Analysis

verfasst von: Yi-Yang Lin, Rheun-Chuan Lee, Hsiuo-Shan Tseng, Chien-An Liu, Wan-Yuo Guo, Cheng-Yen Chang

Erschienen in: CardioVascular and Interventional Radiology | Ausgabe 6/2015

Einloggen, um Zugang zu erhalten

Abstract

Purpose

To quantitatively measure the hemodynamic change of hepatic artery before and after transcatheter arterial chemoembolization (TACE) of hepatocellular carcinoma (HCC) by quantitative color-coding analysis (QCA).

Materials and Methods

This prospective study registered 64 consecutive HCC patients who underwent segmental or subsegmental TACE with epirubicin and lipiodol at level 2 or 3 of the subjective angiographic chemoembolization endpoint. QCA was used to determine the maximal density time (T max) of selected intravascular region of interest (ROI). Relative T max (rT max) was defined as the T max at the selected ROI minus the time of contrast medium spurting from the catheter tip. The rT max of hepatic arteries was analyzed before and after embolization.

Results

The pre- and post-treatment rT max of the landmarks at the treated segmental artery were 1.96 ± 0.48 and 3.14 ± 1.77 s, p < 0.001. According to the treated lobe, 30 patients were treated for the right lobe alone, and 8 patients were treated for the left lobe alone. The pre- and post-rT max of treated segmental artery were 2.06 ± 0.54, 3.34 ± 1.63 s, p < 0.001 and 1.89 ± 0.45, 2.68 ± 1.46 s, p = 0.12, respectively. The rT max of the proximal lobar hepatic arteries or proper hepatic artery had no significant change before and after TACE.

Conclusions

The QCA is feasible to quantify embolization endpoints by comparing the rT max in selected hepatic arteries before and after TACE. The rT max of treated segmental artery was significant prolonged after optimized procedures.
Literatur
1.
Zurück zum Zitat Parkin DM, Bray F, Ferlay J, Pisani P. Global cancer statistics, 2002. CA Cancer J Clin. 2005;55(2):74–108.CrossRefPubMed Parkin DM, Bray F, Ferlay J, Pisani P. Global cancer statistics, 2002. CA Cancer J Clin. 2005;55(2):74–108.CrossRefPubMed
2.
Zurück zum Zitat Mazzaferro V, Regalia E, Doci R, Andreola S, Pulvirenti A, Bozzetti F, et al. Liver transplantation for the treatment of small hepatocellular carcinomas in patients with cirrhosis. N Engl J Med. 1996;334(11):693–9.CrossRefPubMed Mazzaferro V, Regalia E, Doci R, Andreola S, Pulvirenti A, Bozzetti F, et al. Liver transplantation for the treatment of small hepatocellular carcinomas in patients with cirrhosis. N Engl J Med. 1996;334(11):693–9.CrossRefPubMed
3.
Zurück zum Zitat Llovet JM, Real MI, Montaña X, Planas R, Coll S, Aponte J, et al. Arterial embolisation or chemoembolisation versus symptomatic treatment in patients with unresectable hepatocellular carcinoma: a randomised controlled trial. Lancet. 2002;359(9319):1734–9.CrossRefPubMed Llovet JM, Real MI, Montaña X, Planas R, Coll S, Aponte J, et al. Arterial embolisation or chemoembolisation versus symptomatic treatment in patients with unresectable hepatocellular carcinoma: a randomised controlled trial. Lancet. 2002;359(9319):1734–9.CrossRefPubMed
4.
Zurück zum Zitat Lo CM, Ngan H, Tso WK, Liu CL, Lam CM, Poon RT, et al. Randomized controlled trial of transarterial lipiodol chemoembolization for unresectable hepatocellular carcinoma. Hepatology. 2002;35(5):1164–71.CrossRefPubMed Lo CM, Ngan H, Tso WK, Liu CL, Lam CM, Poon RT, et al. Randomized controlled trial of transarterial lipiodol chemoembolization for unresectable hepatocellular carcinoma. Hepatology. 2002;35(5):1164–71.CrossRefPubMed
5.
Zurück zum Zitat European Association for the Study of the Liver, European Organisation For Research and Treatment of Cancer. EASL-EORTC clinical practice guidelines: management of hepatocellular carcinoma. J Hepatol. 2012;56(4):908–43.CrossRef European Association for the Study of the Liver, European Organisation For Research and Treatment of Cancer. EASL-EORTC clinical practice guidelines: management of hepatocellular carcinoma. J Hepatol. 2012;56(4):908–43.CrossRef
6.
Zurück zum Zitat Belghiti J, Carr BI, Greig PD, Lencioni R, Poon RT. Treatment before liver transplantation for HCC. Ann Surg Oncol. 2008;15(4):993–1000.CrossRefPubMed Belghiti J, Carr BI, Greig PD, Lencioni R, Poon RT. Treatment before liver transplantation for HCC. Ann Surg Oncol. 2008;15(4):993–1000.CrossRefPubMed
7.
Zurück zum Zitat Scatton O, Liddo G, Belghiti J. Liver transplantation for hepatocellular carcinoma: current topics in France. J Hepatobiliary Pancreat Sci. 2010;17(5):567–73.CrossRefPubMed Scatton O, Liddo G, Belghiti J. Liver transplantation for hepatocellular carcinoma: current topics in France. J Hepatobiliary Pancreat Sci. 2010;17(5):567–73.CrossRefPubMed
8.
Zurück zum Zitat Livraghi T, Meloni F, Morabito A, Vettori C. Multimodal image-guided tailored therapy of early and intermediate hepatocellular carcinoma: long-term survival in the experience of a single radiologic referral center. Liver Transpl. 2004;10(2 Suppl 1):S98–106.CrossRefPubMed Livraghi T, Meloni F, Morabito A, Vettori C. Multimodal image-guided tailored therapy of early and intermediate hepatocellular carcinoma: long-term survival in the experience of a single radiologic referral center. Liver Transpl. 2004;10(2 Suppl 1):S98–106.CrossRefPubMed
9.
Zurück zum Zitat Maeda S, Fujiyama S, Tanaka M, Ashihara H, Hirata R, Tomita K. Survival and local recurrence rates of hepatocellular carcinoma patients treated by transarterial chemolipiodolization with and without embolization. Hepatol Res. 2002;23(3):202–10.CrossRefPubMed Maeda S, Fujiyama S, Tanaka M, Ashihara H, Hirata R, Tomita K. Survival and local recurrence rates of hepatocellular carcinoma patients treated by transarterial chemolipiodolization with and without embolization. Hepatol Res. 2002;23(3):202–10.CrossRefPubMed
10.
Zurück zum Zitat Ikeda M, Maeda S, Shibata J, Muta R, Ashihara H, Tanaka M, et al. Transcatheter arterial chemotherapy with and without embolization in patients with hepatocellular carcinoma. Oncology. 2004;66(1):24–31.CrossRefPubMed Ikeda M, Maeda S, Shibata J, Muta R, Ashihara H, Tanaka M, et al. Transcatheter arterial chemotherapy with and without embolization in patients with hepatocellular carcinoma. Oncology. 2004;66(1):24–31.CrossRefPubMed
11.
Zurück zum Zitat Jin B, Wang D, Lewandowski RJ, Riaz A, Ryu RK, Sato KT, et al. Chemoembolization endpoints: effect on survival among patients with hepatocellular carcinoma. Am J Roentgenol. 2011;196(4):919–28.CrossRef Jin B, Wang D, Lewandowski RJ, Riaz A, Ryu RK, Sato KT, et al. Chemoembolization endpoints: effect on survival among patients with hepatocellular carcinoma. Am J Roentgenol. 2011;196(4):919–28.CrossRef
12.
Zurück zum Zitat Gaba RC. Chemoembolization practice patterns and technical methods among interventional radiologists: results of an online survey. Am J Roentgenol. 2012;198(3):692–9.CrossRef Gaba RC. Chemoembolization practice patterns and technical methods among interventional radiologists: results of an online survey. Am J Roentgenol. 2012;198(3):692–9.CrossRef
13.
Zurück zum Zitat Lewandowski RJ, Wang D, Gehl J, Atassi B, Ryu RK, Sato K, et al. A comparison of chemoembolization endpoints using angiographic versus transcatheter intraarterial perfusion/MR imaging monitoring. J Vasc Interv Radiol. 2007;18(10):1249–57.CrossRefPubMed Lewandowski RJ, Wang D, Gehl J, Atassi B, Ryu RK, Sato K, et al. A comparison of chemoembolization endpoints using angiographic versus transcatheter intraarterial perfusion/MR imaging monitoring. J Vasc Interv Radiol. 2007;18(10):1249–57.CrossRefPubMed
14.
Zurück zum Zitat Jin B, Wang D, Lewandowski RJ, Ryu RK, Sato KT, Larson AC, et al. Quantitative 4D transcatheter intraarterial perfusion MRI for standardizing angiographic chemoembolization endpoints. Am J Roentgenol. 2011;197(5):1237–43.CrossRef Jin B, Wang D, Lewandowski RJ, Ryu RK, Sato KT, Larson AC, et al. Quantitative 4D transcatheter intraarterial perfusion MRI for standardizing angiographic chemoembolization endpoints. Am J Roentgenol. 2011;197(5):1237–43.CrossRef
15.
Zurück zum Zitat Gaba RC, Wang D, Lewandowski RJ, Ryu RK, Sato KT, Kulik LM, et al. Four-dimensional transcatheter intraarterial perfusion MR imaging for monitoring chemoembolization of hepatocellular carcinoma: preliminary results. J Vasc Interv Radiol. 2008;19(11):1589–95.PubMedCentralCrossRefPubMed Gaba RC, Wang D, Lewandowski RJ, Ryu RK, Sato KT, Kulik LM, et al. Four-dimensional transcatheter intraarterial perfusion MR imaging for monitoring chemoembolization of hepatocellular carcinoma: preliminary results. J Vasc Interv Radiol. 2008;19(11):1589–95.PubMedCentralCrossRefPubMed
16.
Zurück zum Zitat Larson AC, Wang D, Atassi B, Sato KT, Ryu RK, Lewandowski RJ, et al. Transcatheter intraarterial perfusion: MR monitoring of chemoembolization for hepatocellular carcinoma—feasibility of initial clinical translation. Radiology. 2008;246(3):964–71.CrossRefPubMed Larson AC, Wang D, Atassi B, Sato KT, Ryu RK, Lewandowski RJ, et al. Transcatheter intraarterial perfusion: MR monitoring of chemoembolization for hepatocellular carcinoma—feasibility of initial clinical translation. Radiology. 2008;246(3):964–71.CrossRefPubMed
17.
Zurück zum Zitat Zhang XB, Zhuang ZG, Ye H, Beilner J, Kowarschik M, Chen JJ, et al. Objective assessment of transcatheter arterial chemoembolization angiographic endpoints: preliminary study of quantitative digital subtraction angiography. J Vasc Interv Radiol. 2013;24(5):667–71.CrossRefPubMed Zhang XB, Zhuang ZG, Ye H, Beilner J, Kowarschik M, Chen JJ, et al. Objective assessment of transcatheter arterial chemoembolization angiographic endpoints: preliminary study of quantitative digital subtraction angiography. J Vasc Interv Radiol. 2013;24(5):667–71.CrossRefPubMed
18.
Zurück zum Zitat Kennedy AS, Kleinstreuer C, Basciano CA, Dezarn WA. Computer modeling of yttrium-90-microsphere transport in the hepatic arterial tree to improve clinical outcomes. Int J Radiat Oncol Biol Phys. 2010;76(2):631–7.CrossRefPubMed Kennedy AS, Kleinstreuer C, Basciano CA, Dezarn WA. Computer modeling of yttrium-90-microsphere transport in the hepatic arterial tree to improve clinical outcomes. Int J Radiat Oncol Biol Phys. 2010;76(2):631–7.CrossRefPubMed
19.
Zurück zum Zitat Davis B, Royalty K, Kowarschik M, Rohkohl C, Oberstar E, Aagaard-Kienitz B, et al. 4D digital subtraction angiography: implementation and demonstration of feasibility. Am J Neuroradiol. 2013;34(10):1914–21.CrossRefPubMed Davis B, Royalty K, Kowarschik M, Rohkohl C, Oberstar E, Aagaard-Kienitz B, et al. 4D digital subtraction angiography: implementation and demonstration of feasibility. Am J Neuroradiol. 2013;34(10):1914–21.CrossRefPubMed
20.
Zurück zum Zitat Parry PV, Ducruet AF. Four-dimensional digital subtraction angiography: implementation and demonstration of feasibility. World Neurosurg. 2014;81(3–4):454–5.CrossRefPubMed Parry PV, Ducruet AF. Four-dimensional digital subtraction angiography: implementation and demonstration of feasibility. World Neurosurg. 2014;81(3–4):454–5.CrossRefPubMed
Metadaten
Titel
Objective Measurement of Arterial Flow Before and After Transcatheter Arterial Chemoembolization: A Feasibility Study Using Quantitative Color-Coding Analysis
verfasst von
Yi-Yang Lin
Rheun-Chuan Lee
Hsiuo-Shan Tseng
Chien-An Liu
Wan-Yuo Guo
Cheng-Yen Chang
Publikationsdatum
01.12.2015
Verlag
Springer US
Erschienen in
CardioVascular and Interventional Radiology / Ausgabe 6/2015
Print ISSN: 0174-1551
Elektronische ISSN: 1432-086X
DOI
https://doi.org/10.1007/s00270-015-1111-6

Weitere Artikel der Ausgabe 6/2015

CardioVascular and Interventional Radiology 6/2015 Zur Ausgabe

Update Radiologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.