The value of computed tomography perfusion for assessing the response of hepatocellular carcinoma to transarterial chemoembolization

Abstract

We determined the value of computed tomography perfusion (CTP) for assessing the response of hepatocellular carcinoma (HCC) to transarterial chemoembolization (TACE). 20 post-TACE HCC patients were re-evaluated with contrast-enhanced computed tomography and CTP. Patients with persistent arterial vascularization [non-response (NR)] or those with no arterial vascularization in the mass, but with signs of new nodules, underwent digital subtraction angiography (DSA), which was used to analyze image characteristics and CTP parameters of TACE-treated HCC. 27 post-TACE HCC masses (mean size 4.21 cm, range 2-6.5 cm) were observed in the 20 patients. The values yielded by CTP were 78.30±40.41 mL/min/100g and 33.67±38.74 mL/min/100g for hepatic arterial blood flow (HABF) and 51.40±17.80% and 25.60±26.53% for hepatic arterial fraction (HAF) in the NR group and complete response group, respectively. The NR group’s cutoff value of HABF was ≥55.95 mL/min/100g, with a sensitivity of 91.7% and specificity of 71.42%, and that of HAF was ≥32.55%, with a sensitivity of 92.3% and specificity of 83.33%. The CTP and DSA techniques showed high agreement in assessing the post-TACE responses of liver tumors (κ=0.872). The perfusion parameters HABF and HAF have high value for assessing post-TACE responses of HCC.