Comparative Study for Identification of Feeding Arteries of Hepatocellular Carcinoma by 3D Reformatted CT Angiography and Digital Subtraction Angiography during Transcatheter Arterial Chemoembolization (TACE)

Abstract

The main treatment of intermediate-stage hepatocellular carcinoma (HCC) is considered to be transcatheter arterial chemoembolization  (TACE).

Objective: To compare the accuracy of 3D reformatted computed tomography (CT) angiography and digital subtraction  angiography (DSA) during TACE for the identification of feeding arteries of hepatocellular carcinoma.

Patients and Methods: This  prospective study was performed on 50 cases already diagnosed with HCC. Arterial phase multidetector-row CT (MDCT) images were  retrospectively reformatted and analyzed to determine the anatomical variants of hepatic arterial supply and tumor-feeding vessel using  maximum intensity projection (MIP), multi-planar reconstruction (MPR), and volume-rendering (VR) technique and compared to results  of DSA done during TACE.

Results: The whole number of HCC lesions was 68 lesions. The accuracy of CT angiography using MIP and VR  techniques for assessing hepatic artery variations was (100%) in MIP and (94%) in VR technique compared to DSA done during TACE. The  total number of feeding arteries was 96 feeder arteries; 93 feeders were from hepatic artery branches and only 3 feeders were extra- hepatic. The accuracy of assessing the feeding arteries of HCC was (87.5%) in MIP and (24%) in VR techniques compared to DSA results.  

Conclusions: For evaluating HCC feeding arteries, CT angiography with MIP demonstrated more accuracy and superior image quality  than the VR technique compared with DSA done during TACE.