Detecting hepatic nodules and identifying feeding arteries of hepatocellular carcinoma: efficacy of cone-beam computed tomography in transcatheter arterial chemoembolization

Aim: To evaluate the effectiveness of using cone-beam computed tomography (CBCT) in transcatheter arterial chemoembolization (TACE) to detect hapatocellular carcinoma (HCC) nodules and their feeding arteries.Methods: Twenty-four patients with HCCs who underwent TACE using CBCT in addition to conventional digital subtraction angiography (DSA) were enrolled. After both conventional DSA and CBCT through the hepatic artery were acquired, TACE were performed. The nodules were defined as an HCC when dense accumulation of iodized oil was found within the nodule on CT obtained 2 weeks after the TACE. The number of detected nodules and identified feeding arteries, and their correlations with anatomical locations were assessed.Results: A total of 39 HCC nodules (tumor diameter, 7-40 mm; mean, 17.4 ± 7.9 mm) were detected. Thirty-one nodules were detected by DSA alone but 8 nodules were additionally detected by adding CBCT to DSA. There were 53 feeding arteries associated with the 39 HCC nodules. Among these arteries, 21 were identified by DSA alone; however, 47 were identified by combining CBCT with DSA. Additional feeding arteries, especially for the nodules located at the right and caudate lobes, were identified by CBCT. On the other hand, there was no difference in detection of nodules between the anatomical locations by CBCT.Conclusion: The use of CBCT in addition to DSA offers potential for increasing the number of detected nodules, and the number of their feeding arteries at the right and caudate lobes. CBCT might improve the quality of TACE procedure for HCC than DSA alone