Usefulness of fusion images of unenhanced and contrast-enhanced arterial phase cone-beam CT in the detection of viable hepatocellular carcinoma during transarterial chemoembolization

Özet

PURPOSEWe aimed to evaluate the diagnostic efficacy of fusion imaging of unenhanced and arterialphase contrast-enhanced cone-beam computed tomography (CBCT) by comparing with multidetectorcomputed tomography (MDCT) in detection of viable hepatocellular carcinoma (HCC)in patients who have been previously treated with transarterial chemoembolization (TACE).METHODSIn this retrospective study, a total of 173 tumors in 33 known HCC patients (21 men, 12 women;mean age, 64±7.6 years; mean tumor size, 2.15±1.70 cm) who had been previously treatedwith TACE and underwent additional session of TACE were included. The sensitivity and positivepredictive values of preprocedural MDCT and fusion CBCT for detection of viable tumor wereanalyzed with follow-up MDCT images performed 3-4 weeks after TACE, as reference standard.RESULTSA total of 141 remote and 32 marginal viable tumors were included. The sensitivities for detectionof remote, marginal, and total viable tumors were 80.9%, 68.8%, and 78.6% for MDCT and96.5%, 96.9%, and 96.5% for fusion CBCT, respectively. The positive predictive values for detectionof remote, marginal, and total viable tumors were 95.0%, 78.6%, and 95.8% for MDCT, and97.1%, 88.6%, and 97.7% for fusion CBCT, respectively. Fusion CBCT showed statistically highersensitivity and positive predictive value for detection of viable tumors (P < 0.001).CONCLUSIONThe diagnostic performance of fusion imaging of unenhanced and contrast-enhanced arterialphase CBCT was superior to MDCT for detection of viable HCCs.