Utility Of C-Arm CT In Detection Of Hepatocellular Carcinoma Duringtransarterial Chemoembolization
European Journal of Molecular & Clinical Medicine,
2020, Volume 7, Issue 8, Pages 2428-2439
AbstractBackground:The development of flat panel detectors has made cone-beam CT feasible for practical use in a clinical setting, the aim of this study isto assess the usefulness of C-arm Cone beam Computed Tomography (CBCT) in conjunction with conventional digital subtraction angiography (DSA) in detection of the tumors and identifying the feeding vessels during transarterial chemoembolization of hepatocellular carcinoma (HCC). Material and Methods: Between January 2016 and January 2018, cone beam CT was retrospectively used in 19 consecutive patients with HCC tumors, 12 patients (63.2%) done CT as a pre imaging modality and 7 patients (36.8%) done MRI. Detectability of tumors and tumor-feeding subsegmental arteries was compared versus that ofpreimaging CT or MRI and the nonselective digital subtraction angiography (DSA). Results:DSA depicted additional 14 (38.8 %) lesions were not apparent in the pre imaging (CT/MRI) and CBCT depicted additional 21(58.3%) lesions were not apparent in the pre imaging (CT/MRI). Tumor detectability on DSA was no statistically significant difference from pre imaging (CT/MRI) (P = 0.075), The sensitivity and specificity of DSA in detection of tumors taking the imaging (CT/MRI) as a gold standard was (88.9%), (84.5%) respectively with accuracy (85.53%). Tumor detectability on cone-beam CT was high significantly greater than on preimaging (CT/MRI) modality(p=0.000) .The sensitivity and specificity of CBCT in detection of tumors taking the imaging (CT/MRI) as a gold standard was (94.4%), (71.6%) respectively with accuracy (76.97%). DSA could detect 54 feeding vessels for all tumors detected by DSA. CBCT could detect 101 feeding vessels for all tumors detected by CBCT. The detectability of tumor-feeding branches with CBCT was highly significantly than that with DSA (P= 0.004) Conclusion:C-arm CT is a useful collaborative tool in patients undergoing transhepatic arterial chemoembolization thereby improving the detection of tumor as well as their feeding vessels, We believe the technical success rates of ultraselectivetranscatheter arterial chemoembolization may be improved by chemoembolization guidance software that uses conebeam CT technology.
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