Department of Diagnostic Radiology, Fukuiken Saiseikai Hospital, 7-1 Funabashi, Wadanaka-cho, Fukui 918-8503, Japan.
Jpn J Radiol. 2011 Jul;29(6):371-7. doi: 10.1007/s11604-011-0568-8. Epub 2011 Jul 24.
Cone-beam computed tomography (CBCT) using a flat-panel detector is an alternative method of obtaining cross-sectional images. This technique is now being used during transcatheter arterial chemoembolization (TACE) for inoperable hepatocellular carcinoma (HCC). Several CBCT techniques are performed to detect HCC lesions: CBCT during portography (CBCTAP), CBCT during hepatic arteriography (CBCTHA), CBCT after iodized oil injection (LipCBCT), CBCT during arteriography (CBCTA) of extrahepatic collaterals. Almost all HCC lesions can be detected using these CBCT images. Three-dimensional arteriography using maximum intensity projection from CBCTHA images can identify the tumor-feeding branch. In particular, this technique is useful when the tumor stain cannot be demonstrated on arteriography. In addition, dual-phase CBCTHA can improve the diagnostic accuracy for hypervascular HCCs because corona enhancement can be detected around the tumor. To monitor the embolized area during TACE, selective CBCTHA or LipCBCT at the embolization point is useful. Two sequential CBCT scans without and with contrast material injection is also useful to confirm each embolized area of two vessels. Furthermore, CBCTA can prevent nontarget embolization. Although the image quality of CBCT is low compared to that of conventional CT, CBCT provides useful information that helps perform TACE for HCCs safely and effectively.
锥形束计算机断层扫描（CBCT）使用平板探测器是获取横截面图像的替代方法。该技术现在正用于经导管动脉化疗栓塞（TACE）治疗不可切除的肝细胞癌（HCC）。有几种 CBCT 技术可用于检测 HCC 病变：门静脉造影时的 CBCT（CBCTAP）、肝动脉造影时的 CBCT（CBCTHA）、碘化油注射后的 CBCT（LipCBCT）、肝外侧支血管造影时的 CBCT（CBCTA）。几乎所有 HCC 病变都可以通过这些 CBCT 图像检测到。从 CBCTHA 图像的最大强度投影进行三维动脉造影可以识别肿瘤供血分支。特别是在动脉造影不能显示肿瘤染色的情况下，这项技术非常有用。此外，双期 CBCTHA 可以提高富血管性 HCC 的诊断准确性，因为可以检测到肿瘤周围的冠状增强。为了在 TACE 期间监测栓塞区域，在栓塞点进行选择性 CBCTHA 或 LipCBCT 是有用的。不注射造影剂和注射造影剂的两次连续 CBCT 扫描也有助于确认两条血管的每个栓塞区域。此外，CBCTA 可以防止非靶向栓塞。虽然与常规 CT 相比，CBCT 的图像质量较低，但它提供了有用的信息，有助于安全有效地进行 HCC 的 TACE。
