The objective of the study was to determine the additional value of contrast-enhanced computed tomography (CECT) in the evaluation of vascular characteristics of hepatocellular carcinoma (HCC) before transarterial chemoembolization (TACE).
Materials and methods. A cross-sectional study was conducted on 116 HCC patients who underwent TACE at Hue University of Medicine and Pharmacy Hospital (Vietnam), from January 2019 to December 2022. Vascular patterns of HCC at CECT were documented and correlated with digital subtraction angiography (DSA).
Results. The mean age of the patienst was 62.7±11.1 years, the average HCC diameter was 6.2± 3.6cm, (range 1–18cm). The vascular patterns of HCC at CECT and DSA were hyper attenuating/tumor staining (92.2% vs. 94.8%), tumor feeder hypertrophy (62.1% vs. 80.2%), neovascularity (60.3% vs. 79.3%), arterioportal shunt (APS, 3.4% vs. 3.4%), extrahepatic parasitic (EHC) supply (17.2% vs. 13.8%), and anatomical variations (17.2% vs. 18.1%), respectively. Compared with DSA, CECT had moderate sensitivity in displaying intra-tumoral neovascularity (76.1%) and hypertrophy of feeding artery (74.2%), but high sensitivity and specificity in detecting APS, EHC supply, and anatomical variations. On binary logistic regression analysis, the tumour maximal diameter was a predictor of intra-tumoural neovascularity, hypertrophy of feeding artery, and portal vein thrombosis at CECT. The number of TACE was positively correlated with the occurrence of EHC arteries (OR: 2.3, 95%CI 1.5 – 3.7, p< 0.01).
Conclusions. CECT has moderate sensitivity in displaying intra-tumoural neovascularity and hypertrophy of feeding artery, but high sensitivity and specificity in detecting APS, EHC arteries, and anatomical variations.
Keywords: hepatocellular carcinoma, computed tomography, digital subtraction angiography, trans-arterial chemoembolization.
Full text sources https://doi.org/10.31688/ABMU.2023.58.4.01
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Address for correspondence:
Le Trong Binh
Department of Radiology, Hue University of Medicine and Pharmacy, Hue University
Address: 06 Ngo Quyen, Hue, Vietnam
Email: letrongbinh@hueuni.edu.vn, ltbinh.cdha@huemed-univ.edu.vn
