Can Software Accurately Estimate Embolic Area in cTACE?

A commercially available 3-dimensional (3D) workstation and liver analysis software can be useful for estimating the embolic area in conventional transarterial chemoembolization (cTACE) for hepatocellular carcinoma (HCC), according to a study published in the journal CardioVascular and Interventional Radiology.

The researchers used a commercially available 3D workstation and liver analysis software to evaluate the accuracy of determining the virtual liver parenchymal perfusion area in cTACE for HCC. The method was retrospectively applied to 29 TACE procedures in 23 patients who were treated at the researchers’ hospital. 

A group of experts (group A) and a group of semi-experts (group B) used the workstation and liver analysis software to estimate virtual embolic area based on cone beam computed tomography during hepatic arteriography. Real embolic area was considered. Group A and group B estimated the real embolic area, defined as the area where iodized oil accumulated on computed tomography at 1 week after cTACE. The mean of both groups’ estimation was used as a standard reference.

In both groups, the agreement between virtual embolic area and real embolic area mean was excellent, although the group of semi-experts had slightly less accurate results than the group of experts. The researchers surmise that this may be because the group of semi-experts had less experience in identifying and extracting a fine hepatic artery when manually estimating the virtual embolic area.

“This method can be useful for estimating the embolic area in cTACE. However, at present, it takes time to process data. Therefore, further improvements are needed and several problems remain to be solved before use of this new method can be recommended in clinical practice,” the study’s authors concluded.

 

Reference

Kinoshita M, Takechi K, Arai Y, et al. Utility of the virtual liver parenchymal perfusion area using a commercially available workstation in transarterial chemoembolization for hepatocellular carcinoma. Cardiovasc Intervent Radiol. 2018 July 23:1-9. [Epub ahead of print] doi.org/10.1007/s00270-018-2041-x.