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Erschienen in: Hepatology International 4/2007

01.12.2007 | Original Research

Iodized oil accumulation in the hypovascular tumor portion of early-stage hepatocellular carcinoma after ultraselective transcatheter arterial chemoembolization

verfasst von: Shiro Miyayama, Osamu Matsui, Masashi Yamashiro, Yasuji Ryu, Harumi Takata, Taro Takeda, Hiroyuki Aburano, Noriaki Shigenari

Erschienen in: Hepatology International | Ausgabe 4/2007

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Abstract

Purpose

We evaluated iodized oil accumulation in the hypovascular portion of early-stage hepatocellular carcinoma (HCC) after ultraselective transcatheter arterial embolization (TACE).

Materials and methods

Forty-seven HCC lesions with hypovascular portions were treated by TACE at the distal level of the sub-subsegmental artery of the liver. Portal blood in the hypovascular portion was classed in two grades by computed tomography (CT) during arterial portography: decreased and preserved. Iodized oil accumulation was classed into three grades on CT obtained 1 week after TACE: (1) dense accumulation in the almost entire tumor, including the hypovascular portion (grade 2); (2) dense accumulation in hypervascular portions but sparse accumulation in hypovascular portion (grade 1); and (3) sparse accumulation or no accumulation (grade 0). Findings on serial follow-up CT images were also analyzed.

Results

Portal blood in the hypovascular portion was decreased in 32 lesions, and preserved in 15 lesions. On CT 1 week after TACE, 32 tumors (68.1%)—23 with decreased portal blood and 9 with preserved portal blood—were classed as grade 2. Twelve tumors (25.5%), six with decreased portal blood and six with preserved portal blood, were classed as grade 1. Three tumors (6.4%) with decreased portal blood were classed into grade 0. In total, 25 tumors (53.2%), 22 in grade 2 and 3 in grade 1, were well controlled by ultraselective TACE during the mean follow-up of 15.8 months.

Conclusions

Iodized oil accumulation and retention in the hypovascular portion of early-stage HCC was frequently observed after ultraselective TACE, mainly in the hypovascular portion with decreased portal blood.
Literatur
1.
Zurück zum Zitat Sakamoto M, Hirohashi S, Shimosato Y. Early stages of multistep hepatocarcinogenesis: adenomatous hyperplasia and early hepatocellular carcinoma. Hum Pathol 1991;22:172–8.PubMedCrossRef Sakamoto M, Hirohashi S, Shimosato Y. Early stages of multistep hepatocarcinogenesis: adenomatous hyperplasia and early hepatocellular carcinoma. Hum Pathol 1991;22:172–8.PubMedCrossRef
2.
Zurück zum Zitat Matsui O, Kadoya M, Kameyama T, Yoshikawa J, Takashima T, Nakanuma Y, et al. Benign and malignant nodules in cirrhotic livers: distinction based on blood supply. Radiology 1991;178:493–7.PubMed Matsui O, Kadoya M, Kameyama T, Yoshikawa J, Takashima T, Nakanuma Y, et al. Benign and malignant nodules in cirrhotic livers: distinction based on blood supply. Radiology 1991;178:493–7.PubMed
3.
Zurück zum Zitat Choi BI, Takayasu K, Han MC. Small hepatocellular carcinomas and associated nodular lesions of the liver: pathology, pathogenesis, and imaging findings. Am J Roentgenol 1993;160:1177–87. Choi BI, Takayasu K, Han MC. Small hepatocellular carcinomas and associated nodular lesions of the liver: pathology, pathogenesis, and imaging findings. Am J Roentgenol 1993;160:1177–87.
4.
Zurück zum Zitat Hayashi M, Matsui O, Ueda K, Kwamori Y, Kadoya M, Yoshikawa J, et al. Correlation between the blood supply and grade of malignancy of hepatocellular nodules associated with liver cirrhosis: evaluation by CT during intraarterial injection of contrast medium. Am J Roentgenol 1999;172:969–76. Hayashi M, Matsui O, Ueda K, Kwamori Y, Kadoya M, Yoshikawa J, et al. Correlation between the blood supply and grade of malignancy of hepatocellular nodules associated with liver cirrhosis: evaluation by CT during intraarterial injection of contrast medium. Am J Roentgenol 1999;172:969–76.
5.
Zurück zum Zitat Hayashi M, Matsui O, Ueda K, Kawamori Y, Gabata T, Kadoya M. Progression to hypervascular hepatocellular carcinoma: correlation with intranodular blood supply evaluated with CT during intraarterial injection of contrast material. Radiology 2002;225:143–9.PubMedCrossRef Hayashi M, Matsui O, Ueda K, Kawamori Y, Gabata T, Kadoya M. Progression to hypervascular hepatocellular carcinoma: correlation with intranodular blood supply evaluated with CT during intraarterial injection of contrast material. Radiology 2002;225:143–9.PubMedCrossRef
6.
Zurück zum Zitat Honda H, Tajima T, Kajiyama K, Kuroiwa T, Yoshimitsu K, Irie H, et al. Vascular changes in hepatocellular carcinoma: correlation of radiologic and pathologic findings. Am J Roentgenol 1999;173:1213–7. Honda H, Tajima T, Kajiyama K, Kuroiwa T, Yoshimitsu K, Irie H, et al. Vascular changes in hepatocellular carcinoma: correlation of radiologic and pathologic findings. Am J Roentgenol 1999;173:1213–7.
7.
Zurück zum Zitat Takayasu K, Wakao F, Moriyama N, Muramatsu Y, Sakamoto M, Hirohashi S, et al. Response of early-stage hepatocellular carcinoma and borderline lesions to therapeutic arterial embolization. Am J Roentgenol 1993;160:301–6. Takayasu K, Wakao F, Moriyama N, Muramatsu Y, Sakamoto M, Hirohashi S, et al. Response of early-stage hepatocellular carcinoma and borderline lesions to therapeutic arterial embolization. Am J Roentgenol 1993;160:301–6.
8.
Zurück zum Zitat Ueda K, Saito K, Terada T, Nakanuma Y. Selective necrosis of encapsulated malignant lesion within atypical adenomatous hyperplasia of the liver following transarterial embolization: a report of two autopsy cases. J Clin Gastroenterol 1991;13:709–14.PubMedCrossRef Ueda K, Saito K, Terada T, Nakanuma Y. Selective necrosis of encapsulated malignant lesion within atypical adenomatous hyperplasia of the liver following transarterial embolization: a report of two autopsy cases. J Clin Gastroenterol 1991;13:709–14.PubMedCrossRef
9.
Zurück zum Zitat Miyayama S, Matsui O, Yamashiro M, Ryu Y, Kaito K, Ozaki K, et al. Ultraselective transcatheter arterial chemoembolization using a 2-F tip microcatheter for small hepatocellular carcinomas: relationship between local tumor recurrence and visualization of the portal vein by iodized oil. J Vasc Interv Radiol 2007;18:365–76.PubMedCrossRef Miyayama S, Matsui O, Yamashiro M, Ryu Y, Kaito K, Ozaki K, et al. Ultraselective transcatheter arterial chemoembolization using a 2-F tip microcatheter for small hepatocellular carcinomas: relationship between local tumor recurrence and visualization of the portal vein by iodized oil. J Vasc Interv Radiol 2007;18:365–76.PubMedCrossRef
10.
Zurück zum Zitat Yamada R, Sato M, Kawabata M, Nakatsuka H, Nakamura K, Takashima S. Hepatic artery embolization in 120 patients with unresectable hepatoma. Radiology 1983;148:397–401.PubMed Yamada R, Sato M, Kawabata M, Nakatsuka H, Nakamura K, Takashima S. Hepatic artery embolization in 120 patients with unresectable hepatoma. Radiology 1983;148:397–401.PubMed
11.
Zurück zum Zitat Uchida H, Ohishi H, Matsuo N, Nishimine K, Ohue S, Nishimura Y, et al. Transcatheter hepatic segmental arterial embolization using Lipiodol mixed with an anticancer drug and Gelfoam particles for hepatocellular carcinoma. Cardiovasc Intervent Radiol 1990;13:140–5.PubMedCrossRef Uchida H, Ohishi H, Matsuo N, Nishimine K, Ohue S, Nishimura Y, et al. Transcatheter hepatic segmental arterial embolization using Lipiodol mixed with an anticancer drug and Gelfoam particles for hepatocellular carcinoma. Cardiovasc Intervent Radiol 1990;13:140–5.PubMedCrossRef
12.
Zurück zum Zitat Matsui O, Kadoya M, Yoshikawa J, Gabata T, Arai K, Demachi H, et al. Small hepatocellular carcinoma: treatment with subsegmental transcatheter arterial embolization. Radiology 1993;188:79–83.PubMed Matsui O, Kadoya M, Yoshikawa J, Gabata T, Arai K, Demachi H, et al. Small hepatocellular carcinoma: treatment with subsegmental transcatheter arterial embolization. Radiology 1993;188:79–83.PubMed
13.
Zurück zum Zitat Takayasu K, Muramatsu Y, Maeda T, Iwata R, Furukawa H, Muramatsu Y, et al. Targeted transarterial oily chemoembolization for small foci of hepatocellular carcinoma using a unified helical CT and angiography system: analysis of factors affecting local recurrence and survival rates. Am J Roentgenol 2001;176:681–8. Takayasu K, Muramatsu Y, Maeda T, Iwata R, Furukawa H, Muramatsu Y, et al. Targeted transarterial oily chemoembolization for small foci of hepatocellular carcinoma using a unified helical CT and angiography system: analysis of factors affecting local recurrence and survival rates. Am J Roentgenol 2001;176:681–8.
14.
Zurück zum Zitat Miyayama S, Matsui O, Taki K, Minami T, Ryu Y, Ito C, et al. Arterial blood supply to the posterior aspect of segment IV of the liver from the caudate branch: demonstration at CT after iodized oil injection. Radiology 2005;237:1110–4.PubMedCrossRef Miyayama S, Matsui O, Taki K, Minami T, Ryu Y, Ito C, et al. Arterial blood supply to the posterior aspect of segment IV of the liver from the caudate branch: demonstration at CT after iodized oil injection. Radiology 2005;237:1110–4.PubMedCrossRef
15.
Zurück zum Zitat Nakamura H, Hashimoto T, Oi H, Sawada S. Iodized oil in the portal vein after arterial embolization. Radiology 1988;167:415–7.PubMed Nakamura H, Hashimoto T, Oi H, Sawada S. Iodized oil in the portal vein after arterial embolization. Radiology 1988;167:415–7.PubMed
16.
Zurück zum Zitat Terayama N, Matsui O, Gabata T, Kobayashi S, Sanada J, Ueda K, et al. Accumulation of iodized oil within the non-neoplastic liver adjacent to hepatocellular carcinoma via the drainage routes of the tumor after transcatheter arterial embolization. Cardiovasc Intervent Radiol 2001;24:383–7.PubMedCrossRef Terayama N, Matsui O, Gabata T, Kobayashi S, Sanada J, Ueda K, et al. Accumulation of iodized oil within the non-neoplastic liver adjacent to hepatocellular carcinoma via the drainage routes of the tumor after transcatheter arterial embolization. Cardiovasc Intervent Radiol 2001;24:383–7.PubMedCrossRef
17.
Zurück zum Zitat Miyayama S, Matsui O, Yamashiro M, Ryu Y, Takata H, Takeda T, et al. Detection of hepatocellular carcinoma by CT during arterial portography using a cone-beam CT technology: comparison with conventional CTAP. Abdom Imaging 2007; in press. Miyayama S, Matsui O, Yamashiro M, Ryu Y, Takata H, Takeda T, et al. Detection of hepatocellular carcinoma by CT during arterial portography using a cone-beam CT technology: comparison with conventional CTAP. Abdom Imaging 2007; in press.
18.
Zurück zum Zitat Llovet JM, Vilana R, Bru C, Bianchi L, Salmeron JM, Boix L, et al. Increased risk of tumor seeding after percutaneous radiofrequency ablation for single hepatocellular carcinoma. Hepatology 2001;33:1124–9.PubMedCrossRef Llovet JM, Vilana R, Bru C, Bianchi L, Salmeron JM, Boix L, et al. Increased risk of tumor seeding after percutaneous radiofrequency ablation for single hepatocellular carcinoma. Hepatology 2001;33:1124–9.PubMedCrossRef
19.
Zurück zum Zitat McGahan JP, Dodd GD III. Radiofrequency ablation of the liver: current status. Am J Roentgenol 2001;176:3–16. McGahan JP, Dodd GD III. Radiofrequency ablation of the liver: current status. Am J Roentgenol 2001;176:3–16.
Metadaten
Titel
Iodized oil accumulation in the hypovascular tumor portion of early-stage hepatocellular carcinoma after ultraselective transcatheter arterial chemoembolization
verfasst von
Shiro Miyayama
Osamu Matsui
Masashi Yamashiro
Yasuji Ryu
Harumi Takata
Taro Takeda
Hiroyuki Aburano
Noriaki Shigenari
Publikationsdatum
01.12.2007
Verlag
Springer-Verlag
Erschienen in
Hepatology International / Ausgabe 4/2007
Print ISSN: 1936-0533
Elektronische ISSN: 1936-0541
DOI
https://doi.org/10.1007/s12072-007-9030-5

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