Staging hepatic tumors with CT and carbon dioxide.

OBJECTIVE

Carbon dioxide (CO2) intraarterial dynamic CT (CO2-IADCT) was used to observe the micro- and macrocirculation of hepatic tumors and hepatic parenchyma.

MATERIALS AND METHODS

A total of nine patients with hepatic nodular mass [five patients with hepatocellular carcinoma (HCC), three with metastatic liver cancer originated from colon cancer, and one with cysts] were included in this study. Thirty to fifty milliliters of CO2 was injected into the proper or right hepatic artery, in approximately 15 s, using a manually operated syringe. Consecutive CT scans were performed with a slice thickness of 1 cm, using a TCT 900s (Toshiba Co., Tokyo, Japan), to evaluate visualization of hepatic arteries and portal veins around tumors, tumor vessels, and CO2 bubbles in tumors.

RESULTS

The hepatic arteries and portal vein were revealed in all patients. The tumor vessels were observed in all patients with HCC except one patient who received chemoembolization before this procedure and one of three patients with metastatic liver cancer. The spotty CO2 deposits in the tumor were revealed in all patients, except in two patients with hepatic cysts and embolized HCC. No spotty deposits were seen in the normal liver tissue.

CONCLUSION

Thus, CO2-IADCT provided visualization of tumor vessels, spotty deposits of CO2 in tumors, and retrograde visualization of the portal vein. This method seems to be useful for the precise evaluation of the staging of liver tumors.