SIR 2024
Imaging
Satoshi Tsukahara, MD
graduate student
Department of Radiology, Nagoya City University Graduate School of Medical Sciences, Japan
Financial relationships: Full list of relationships is listed on the CME information page.
Kengo Ohta, MD, PhD
Assistant professor
Department of Radiology, Nagoya City University Graduate School of Medical Sciences, Japan
Disclosure information not submitted.
Kazushi Suzuki, MD, PhD
Assistant professor
Department of Radiology, Nagoya City University Graduate School of Medical Sciences, Japan
Disclosure information not submitted.
Keita Nakayama, MD, PhD
Assistant professor
Department of Radiology, Nagoya City University Graduate School of Medical Sciences, Japan
Disclosure information not submitted.
Shinji Kato, MD
Assistant professor
Department of Radiology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
Disclosure information not submitted.
Shota Ohba, MD, PhD
Assistant professor
Department of Radiology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
Disclosure information not submitted.
Takafumi Sato, MD
Fellow
Department of Radiology, Nagoya City University Hospital, Japan
Financial relationships: Full list of relationships is listed on the CME information page.
Akio Hiwatashi, MD, PhD
Professor
Department of Radiology, Nagoya City University Graduate School of Medical Sciences, Japan
Disclosure information not submitted.
It is crucial to detect feeding arteries before transarterial chemoembolization (TACE) for hepatocellular carcinoma (HCC), however, it is often difficult to identify them on conventional energy-integrating detector CT (EID-CT). Therefore, angio-CT via hepatic arteries is currently a gold standard. On the other hand, recent invent of photon counting detector CT (PCD-CT) is considered to be superior to EID-CT in the ability to visualize small vessels with higher spatial resolution and less noise. Therefore, the purpose of this study was to investigate whether preoperative PCD-CT was useful to identify feeding arteries before TACE.
Materials and methods:
This retrospective study included patients who underwent contrast enhanced PCD-CT before TACE from March to April 2023 in our institution. PCD-CT (contrast agent: iomeprol, dose: 600mgI/kg, injection time: 25s, scan timing: 6 seconds after the descending aorta reached 150 HU, acquisition mode: UltraQuantumplus, kernel: Qr60) was performed within one week before TACE. Angio-CT (contrast agent: Iopamidol, injection rate: 2ml/s, scan timing: 6 seconds after injection from hepatic artery via catheter) was performed during TACE. Feeder on CT was defined as blood vessel connected or closed to tumor stain. All images were evaluated by two radiologists with 14 and 10 years of experience, respectively, in diagnostic and interventional radiology.
Results:
Seven patients met criteria (3 males, 4 females, age ranged from 35 to 84 years, median, 72). There were 9 HCCs with 13 feeders. The feeder identification rate for lesions that were enhanced with preprocedual PCD-CT was 100 % with both preprocedual PCD-CT and angio-CT during procedure and the feeder identification rate of all lesions was 92% and 100%.
Conclusion:
Preprocedual PCD-CT is considered sufficient for feeder identification.