Hatakeyama Kento, Tozawa Tomoki, Wada Yuki, Konno Motoko, Matsuda Masazumi, Otani Takahiro, Minami Shinichiro, Sato Wataru, Nomura Kyoko, Iijima Katsunori, Mori Naoko
Department of Radiology, Akita University Graduate School of Medicine, Akita, Japan.
Division of Gastroenterology, Hepato-biliary-pancreatology and Neurology, Akita University Graduate School of Medicine, Akita, Japan.
J Clin Imaging Sci. 2024 Aug 10;14:29. doi: 10.25259/JCIS_66_2024. eCollection 2024.
The initial drug-eluting bead (DEB)-transarterial chemoembolization (TACE) are often performed after multiple sessions of transarterial infusion chemotherapy (TAI) or conventional TACE. The purpose of our study was to evaluate the factors associated with the occurrence of vascular lake phenomenon (VLP) during DEB-TACE, considering the previous interventional treatments.
Forty-nine initial DEB-TACE procedures in 49 patients between November 2010 and April 2024 were included in this retrospective study. VLP was defined as a localized pooling of contrast agents within the tumor in the venous phase of digital subtraction angiography. The laboratory data, pre-treatment imaging findings such as the maximum tumor diameter (≥3 cm or <3 cm) and the presence of enhancing capsule obtained from computed tomography or magnetic resonance imaging, size of DEBs, and loading drugs, the total number of previous interventional treatments were recorded and compared between VLP occurrence and VLP non-occurrence groups. The multivariate logistic regression analysis was performed to explore the association of factors in predicting VLP occurrence.
VLP was observed in 16 patients (32.65%) out of 49 patients. The maximum tumor diameter (≥3 cm) and the presence of the enhancing capsule were significantly higher, and the total number of previous interventional treatments was significantly smaller in the VLP occurrence group than in the VLP non-occurrence group ( = 0.0006, 0.0007, and 0.0003). In multivariate analysis, the maximum tumor diameter, the presence of the enhancing capsule, and the total number of previous interventional treatments were significantly associated with the occurrence of VLP ( = 0.0048, 0.0093, and 0.047).
Our study confirmed that the reported risk factor, the maximum tumor diameter, and the enhancing capsule were significantly related to the occurrence of VLP in DEB-TACE. Further, the occurrence of VLP might be carefully considered when the number of previous interventional treatments is small.
最初的载药微球（DEB）-经动脉化疗栓塞术（TACE）通常在多次经动脉灌注化疗（TAI）或传统TACE治疗后进行。本研究的目的是考虑先前的介入治疗，评估与DEB-TACE期间血管湖现象（VLP）发生相关的因素。
本回顾性研究纳入了2010年11月至2024年4月期间49例患者的49例初次DEB-TACE手术。VLP被定义为在数字减影血管造影静脉期肿瘤内造影剂的局部聚集。记录实验室数据、治疗前影像学检查结果，如最大肿瘤直径（≥3 cm或<3 cm）以及从计算机断层扫描或磁共振成像获得的强化包膜的存在情况、DEB的大小和加载药物、先前介入治疗的总数，并在VLP发生组和VLP未发生组之间进行比较。进行多因素逻辑回归分析以探讨预测VLP发生的因素之间的关联。
49例患者中有16例（32.65%）观察到VLP。VLP发生组的最大肿瘤直径（≥3 cm）和强化包膜的存在明显更高，而先前介入治疗的总数明显少于VLP未发生组（P = 0.0006、0.0007和0.0003）。在多因素分析中，最大肿瘤直径、强化包膜的存在以及先前介入治疗的总数与VLP的发生显著相关（P = 0.0048、0.0093和0.047）。
我们的研究证实，报告的危险因素、最大肿瘤直径和强化包膜与DEB-TACE中VLP的发生显著相关。此外，当先前介入治疗次数较少时，可能需要仔细考虑VLP的发生情况。
