Tacher Vania, Lin Mingde, Bhagat Nikhil, Abi Jaoudeh Nadine, Radaelli Alessandro, Noordhoek Niels, Carelsen Bart, Wood Bradford J, Geschwind Jean-François
Russell H. Morgan Department of Radiology and Radiological Science, Division of Vascular and Interventional Radiology, The Johns Hopkins Hospital.
J Vis Exp. 2013 Dec 2(82):50795. doi: 10.3791/50795.
The advent of cone-beam computed tomography (CBCT) in the angiography suite has been revolutionary in interventional radiology. CBCT offers 3 dimensional (3D) diagnostic imaging in the interventional suite and can enhance minimally-invasive therapy beyond the limitations of 2D angiography alone. The role of CBCT has been recognized in transarterial chemo-embolization (TACE) treatment of hepatocellular carcinoma (HCC). The recent introduction of a CBCT technique: dual-phase CBCT (DP-CBCT) improves intra-arterial HCC treatment with drug-eluting beads (DEB-TACE). DP-CBCT can be used to localize liver tumors with the diagnostic accuracy of multi-phasic multidetector computed tomography (M-MDCT) and contrast enhanced magnetic resonance imaging (CE-MRI) (See the tumor), to guide intra-arterially guidewire and microcatheter to the desired location for selective therapy (Reach the tumor), and to evaluate treatment success during the procedure (Treat the tumor). The purpose of this manuscript is to illustrate how DP-CBCT is used in DEB-TACE to see, reach, and treat HCC.
血管造影套件中锥形束计算机断层扫描（CBCT）的出现给介入放射学带来了革命性变化。CBCT在介入套件中提供三维（3D）诊断成像，并且能够突破单纯二维血管造影的局限，增强微创治疗效果。CBCT在肝细胞癌（HCC）的经动脉化疗栓塞术（TACE）治疗中的作用已得到认可。最近引入的一种CBCT技术：双期CBCT（DP-CBCT）改善了使用载药微球（DEB-TACE）进行的动脉内HCC治疗。DP-CBCT可用于以多期多层螺旋计算机断层扫描（M-MDCT）和对比增强磁共振成像（CE-MRI）的诊断准确性来定位肝脏肿瘤（见肿瘤），在动脉内引导导丝和微导管到达选择性治疗的理想位置（到达肿瘤），并在手术过程中评估治疗效果（治疗肿瘤）。本手稿的目的是说明DP-CBCT如何在DEB-TACE中用于观察、到达和治疗HCC。
