Tamáska Péter, Ráski Gergely, Pataki Ákos, Lázár István
Klinikai és Intervenciós Radiológiai Centrum, Intervenciós Radiológiai Osztály, Borsod-Abaúj-Zemplén Megyei Kórház és Egyetemi Oktató Kórház 3501 Miskolc, Szentpéteri kapu 72-76.
Magy Seb. 2017 Sep;70(3):213-220. doi: 10.1556/1046.70.2017.3.1.
The role of interventional radiology in the treatment of hepatic malignancies is steeply raising. Our purpose is to present the importance of cone-beam CT (CBCT) during TACE (transarterial chemoembolization) procedures for liver tumours.
Between 1st of June 2013 and 31st of July 2016, we performed 130 TACE procedures in 64 patients in the Borsod University Teaching Hospital at Miskolc. During some of the treatments of 44 patients CBCT was also performed.
All procedures were successful and carried out safely. CBCT gave new information in 22,7%, that influenced further treatment. It helped to precisely localize tumours, corrected the number or the size of hepatic malignancies. With CBCT it was easier to identify the feeding arteries of the tumour, plan the actual treatment and also to assess the efficacy of the previous treatment.
The gold standard therapy of intermediate-stage HCC (according to Barcelona's criteria) is TACE. Beside, it can be safely and efficiently performed also in early stage or advanced stage in cases of contraindications for alternative therapies. Cone-beam CT is a dynamic examination which gives you an intraoperative, 3D CT-like imaging in the angio suit, without moving the table or the catheterised patient. Literature has already cited preliminary datas about prolonged survival for those patients treated with the help of CBCT intraoperatively.
Intraoperative CBCT in patients with TACE treatment for hepatic malignancies can provide information that can improve the therapeutic results. Therefore we suggest the routine use of this imaging option during all TACE procedures if patients are eligible.
介入放射学在肝恶性肿瘤治疗中的作用正在迅速提升。我们的目的是阐述锥形束CT（CBCT）在肝肿瘤经动脉化疗栓塞术（TACE）过程中的重要性。
2013年6月1日至2016年7月31日期间，我们在米什科尔茨的博尔绍德大学教学医院为64例患者进行了130次TACE手术。在44例患者的部分治疗过程中也进行了CBCT检查。
所有手术均成功且安全实施。CBCT提供了22.7%的新信息，这些信息影响了后续治疗。它有助于精确肿瘤定位，校正肝恶性肿瘤的数量或大小。借助CBCT更容易识别肿瘤的供血动脉、规划实际治疗方案以及评估先前治疗的疗效。
中期肝癌（根据巴塞罗那标准）的金标准治疗方法是TACE。此外，在替代疗法存在禁忌证的早期或晚期病例中，也可安全有效地进行TACE。锥形束CT是一种动态检查，可在血管造影套件中提供类似术中3D CT的成像，无需移动手术台或已插管的患者。文献中已经引用了关于术中借助CBCT治疗的患者生存期延长的初步数据。
肝恶性肿瘤TACE治疗患者术中使用CBCT可提供能改善治疗效果的信息。因此，我们建议在所有TACE手术过程中，如果患者符合条件，常规使用这种成像方法。
