Extra-hepatic feeding arteries of hepatocellular carcinoma: An investigation based on intra-arterial CT aortography images using an angio-MDCT system. Issue 8 (August 2016)

• Record Type: Journal Article
• Authors: Takada, Ken; Ito, Takanori; Kumada, Takashi; Toyoda, Hidenori; Tada, Toshifumi; Sone, Yasuhiro; Endo, Tokio; Tanaka, Keisuke; Kitagawa, Hirofumi; Ichikawa, Katsuhiro
• Is Part Of: European journal of radiology. Volume 85:Issue 8(2016)
• Page Start: 1400
• Page End: 1406
• Publication Date: 2016-08
• Subjects: TACE transcatheter arterial chemoembolization -- HCC hepatocellular carcinoma -- EHCAs extra-hepatic collateral feeding arteries -- MDCT multidetector-row computed tomography -- angio-MDCT apparatus that combines multidetector-row computed tomography and angiography system -- 3D 3-dimensional -- OR odds ratio -- CI confidence interval -- DSA digital subtraction angiography -- CT computed tomography -- CTHA computed tomography during hepatic arteriography -- CTA ocomputed tomography during aortography -- HCV hepatitis C virus -- HBV hepatitis B virus -- AFP α-fetoprotein -- AFP-L3 Lens culinaris agglutinin-reactive α-fetoprotein -- DCP des-γ-carboxy prothrombin -- EASL European Association For The Study Of The Liver -- US ultrasonography -- MRI magnetic resonance imaging -- ROC receiver operating characteristic curve -- LAT locoregional ablative therapy -- HAIC hepatic arterial infusion chemotherapy -- RIPA right inferior phrenic artery -- RARA right adrenal artery -- SMA superior mesenteric artery -- RRA right renal artery -- ITA internal thoracic artery; Hepatocellular carcinoma (HCC) -- Extra-hepatic feeding arteries -- Transarterial chemoembolization (TACE) -- Angiography -- Multi detector-row computed tomography (MDCT); Medical radiology -- Periodicals; Radiology -- Periodicals; Radiologie médicale -- Périodiques; Medical radiology; Periodicals; 616.075705
• DOI: 10.1016/j.ejrad.2016.05.007
• Languages: English
• ISSNs: 0720-048X

Abstract

Highlights: We investigated the frequencies and factors associated with the presence of extrahepatic feeding arteries of hepatocellular carcinoma using intraarterial CT aortography images. Repeat transarterial chemoembolization procedures and tumor size were independent risk factors for the presence of extrahepatic feeding arteries of hepatocellular carcinoma. Abstract: Objectives: We investigated the frequencies and factors associated with the presence of extra-hepatic feeding arteries (EHFAs) of hepatocellular carcinoma (HCC) using intra-arterial CT aortography images. Methods: A total of 173 patients with HCC who underwent transarterial chemoembolization (TACE) in our institution between January 2013 and March 2015 were enrolled. The types of EHFAs were evaluated by CT aortography images using an apparatus that combines multidetector-row computed tomography and angiography system. In addition, factors associated with the presence of EHFAs were determined. Results: EHFAs were present in 22 (12.7%) patients with HCC. EHFAs most frequently branched from the right inferior phrenic artery (n = 19), while others branched from the right adrenal artery (n = 2), right renal artery (n = 2), right internal thoracic artery (n = 2), branches of the superior mesenteric artery (n = 1), and an unknown artery from the aorta (n = 1). Factors significantly associated with the presence of EHFAs in multivariate analysis were tumor size ≥ 30 mm (odds ratio (OR), 5.233 [95% confidence interval (CI), 1.507–17.413]; p = 0.009) and number of prior TACE treatments ≥ 3 (OR, 6.847 [95% CI, 1.928–24.311]; p = 0.003). Conclusions: EHFAs of HCC were assessed with CT aortography images. Repeat TACE treatments and large tumor size were risk factors for the presence of EHFAs.