Application Of C-arm Computed Tomography In Accurate Transcatheter Arterial Chemoembolization:A Clinical Study

Purpose:To explore the clinical application value of C-arm computed tomography on enhancing the operating accuracy of transcatheter arterial chemoembolization for liver cancer.Materials and Methods:Between October 2013 and October 2014, collecting 38 patients with primary hepatic carcinomas,38 patients were divided into two groups, group A (20 cases), CACT was used in these cases during the TACE, then all patients undertook the routine CT in 3 days; B group (18 cases), CACT was not used in these cases during the TACE, then all patients undertook the routine CT in 3 days. A x2 test was used to compare the curative effect of interventions with and without CACT, and p values less than 0.05 were consider significant. All transcatheter arterial chemoembolizations (TACE) for 90 patients (Including the 38 cases above) with primary hepatic carcinomas were retrospectively. CACT scans were performed as an adjunct to digital subtraction angiography (DSA).The number of procedures with CACT was recorded. In according to two different scanning types(enhanced and non-enhanced scan), images were post-reconstructed. The interventional doctors make the reasonable judgment depend on the imaging information and the plan for the TACE.ResultsComparing the routine CT of two groups (Group A and Group B) 3 days after operation, which the images show the iodine oil deposition.20 patients of Group A,34 lesions completely iodine oil deposit lesions (type I) accounted for 91.2%(31/34).15 cases of Group B,28 lesions completely iodine oil deposit lesions (type I lesions) accounted for 67.9%(19/28). Routine postoperative CT images of Group A show the iodine oil deposit completely lesions was significantly greater than Group B (x2=5.35, P<0.05).122 TACEs was performed in 90 patients. CACT was not used in 18 patients (20 TACEs). CACT was used in 72 patients (102 TACEs), the total number of CACT was 255, the mean number of acquisitions per study was 2.5(rang,l-8), the number of CACT with selective artery contrast enhanced was 62(in 40 patients,54 TACEs), and the number of non-enhanced CACT was 193 (in 72 patients,102 TACEs). All the CACT scanning could offer extra information, each CACT scan can provide one or more information to help doctors determine. It can acquire these results by selective artery contrast enhanced scanning as follow:1) Found tumour feeder arteries; 2) Show the unknown hepatic artery (which can not be effectively estimated by DSA) and its range of blood supply; 3) Show the non-target arteries(including non-feeder hepatic arteries, cystic artery, and extrahepatic normal blood supply); 4) Show the extrahepatic tumour blood supply. By the non-enhanced CACT:1) Evaluate the embolism; 2) Show the non-target tissue embolism; 3) Recognize the endpoints of TACE.Conclusions:The application of CACT in TACE can make up for the shortage of single DSA imaging, offer a guidance to the interventional doctors for implementing accurate embolism, avoid the occurrence of severe complications, and improve the effect of treatment finally.