Intraprocedural C-Arm Dual-Phase Cone-Beam CT: Can It Be Used to Predict Short-term Response to TACE with Drug-eluting Beads in Patients with Hepatocellular Carcinoma?
Intraprocedural C-Arm Dual-Phase Cone-Beam CT: Can It Be Used to Predict Short-term Response to TACE with Drug-eluting Beads in Patients with Hepatocellular Carcinoma?
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DOI：
10.1148/radiol.12112316
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发表时间：
2013-02-01
期刊：
影响因子：
19.7
通讯作者：
Geschwind, Jean-Francois
中科院分区：
文献类型：
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作者：
Loffroy, Romaric;Lin, MingDe;Geschwind, Jean-Francois
目的：探讨经导管肝动脉化疗栓塞术(TACE)中应用阿霉素洗脱微珠进行C臂双时相锥束CT扫描是否有助于预测肝细胞癌患者术后1个月的肿瘤疗效。材料和方法：本前瞻性研究符合HIPAA标准，并获得机构评审委员会和动物护理与使用委员会的批准。对29例患者(男性16例，女性13例；平均年龄61.9岁+/-10.7岁)的50个靶向肝细胞癌病灶进行了回顾性分析。分别于术前及术后1个月行磁共振成像检查。分别于TACE术前、术后行锥束CT双期扫描。回顾分析锥束CT双期扫描在动脉期和静脉期早期的肿瘤强化情况，并与MR表现进行对照。根据欧洲肝脏研究协会(EASL)的指南，对磁共振成像的肿瘤反应进行评估。两名患者被排除在分析之外，因为双期锥束CT扫描无法解释。相关数据的Logistic回归模型被用来比较不同模式之间肿瘤增强的变化。结果：在1个月的MR成像随访中，动脉和静脉期肿瘤完全和/或部分有效率分别为74%和76%。用配对t检验比较TACE前后的图像显示，两种方法的肿瘤强化程度均显著降低(P
Purpose: To investigate whether C-arm dual-phase cone-beam computed tomography (CT) performed during transcatheter arterial chemoembolization (TACE) with doxorubicin-eluting beads can help predict tumor response at 1-month follow-up in patients with hepatocellular carcinoma (HCC).Materials and Methods: This prospective study was compliant with HIPAA and approved by the institutional review board and animal care and use committee. Analysis was performed retrospectively on 50 targeted HCC lesions in 29 patients (16 men, 13 women; mean age, 61.9 years +/- 10.7) treated with TACE with drug-eluting beads. Magnetic resonance (MR) imaging was performed at baseline and 1 month after TACE. Dual-phase cone-beam CT was performed before and after TACE. Tumor enhancement at dual-phase cone-beam CT in early arterial and delayed venous phases was assessed retrospectively with blinding to MR findings. Tumor response at MR imaging was assessed according to European Association for the Study of the Liver (EASL) guidelines. Two patients were excluded from analysis because dual-phase cone-beam CT scans were not interpretable. Logistic regression models for correlated data were used to compare changes in tumor enhancement between modalities. The radiation dose with dual-phase cone-beam CT was measured in one pig.Results: At 1-month MR imaging follow-up, complete and/or partial tumor response was seen in 74% and 76% of lesions in the arterial and venous phases, respectively. Paired t tests used to compare images obtained before and after TACE showed a significant reduction in tumor enhancement with both modalities (P