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Copyright ©2008 The WJG Press and Baishideng. All rights reserved.
World J Gastroenterol. Oct 7, 2008; 14(37): 5738-5743
Published online Oct 7, 2008. doi: 10.3748/wjg.14.5738
Computed tomography perfusion in evaluating the therapeutic effect of transarterial chemoembolization for hepatocellular carcinoma
Guang Chen, Da-Qing Ma, Wen He, Bao-Feng Zhang, Li-Qin Zhao
Guang Chen, Da-Qing Ma, Wen He, Bao-Feng Zhang, Li-Qin Zhao, Department of Radiology, Beijing Friendship Hospital, Capital Medical University, 95 YongAn Road, Xuan Wu District, Beijing 100050, China
Author contributions: Ma DQ and He W designed the research; Chen G and Zhao LQ performed the data collection, data analysis and statistical analysis; Chen G and Zhang BF performed the clinical studies; Chen G, He W and Zhao LQ drafted and revised the manuscript.
Supported by The Science Technology Program of Beijing Education Committee: KM200810025002
Correspondence to: Wen He, MD, Department of Radiology, Beijing Friendship Hospital, Capital Medical University, 95 Yongan Road, Xuanwu District, Beijing 100050, China. hewen1724@hotmail.com
Telephone: +86-10-63138470 Fax: +86-10-63037216
Received: July 15, 2008
Revised: August 26, 2008
Accepted: September 2, 2008
Published online: October 7, 2008
Abstract

AIM: To prospectively assess the changes in parameters of computed tomography (CT) perfusion pre- and post-transarterial chemoembolization (TACE) of hepatocellular carcinoma (HCC) in different treatment response groups, and to correlate the changes with various responses of HCC to TACE.

METHODS: Thirty-nine HCC patients underwent CT perfusion examinations pre-(1 d before TACE) and post-treatment (4 wk after TACE). The response evaluation criteria for solid tumors (RECIST) were referred to when treatment responses were distributed. Wilcoxon-signed ranks test was used to compare the differences in CT perfusion parameters pre- and post-TACE for different response groups.

RESULTS: Only one case had treatment response to CR and the CT perfusion maps of post-treatment lesion displayed complete absence of signals. In the PR treatment response group, hepatic artery perfusion (HAP), hepatic arterial fracture (HAF) and hepatic blood volume (HBV) of viable tumors post-TACE were reduced compared with pre-TACE (P = 0.001, 0.030 and 0.001, respectively). In the SD group, all CT perfusion parameters were not significantly different pre- and post-TACE. In the PD group, HAP, HAF, portal vein perfusion (PVP) and hepatic blood flow (HBF) of viable tumors post-TACE were significantly increased compared with pre-TACE (P = 0.005, 0.012, 0.035 and 0.005, respectively).

CONCLUSION: Changes in CT perfusion parameters of viable tumors are correlated with different responses of HCC to TACE. Therefore, CT perfusion imaging is a feasible technique for monitoring response of HCC to TACE.

Keywords: Hepatocellular carcinoma, Computed tomography, Transarterial chemoembolization, Digital subtraction arteriography, Region of interest