Tumor Feeding Vessel Detection Software May Impact Local Tumor Response
Use of dedicated tumor feeding vessel detection software (TFVDS) in embolizing hepatocellular carcinoma (HCC) may lead to better local tumor response without an accompanying increase in radiation dose, according to a study published in Cardiovascular and Interventional Radiology.
Previous research has shown that TFVDS can identify tumor feeding vessels better than cone beam CT or 2D digital subtraction angiography alone. The researchers in the current study wanted to see if the promise of TFVDS translates into improved clinical outcomes.
To assess this, they retrospectively analyzed data from 27 patients (19 male, 8 female) who had 44 tumors that were treated via selective hepatic arterial embolization between January 2013 and December 2014. Patients were excluded if they had extra-hepatic supply, more than 4 tumors, tumor size >10 cm, or adjunctive local therapy.
Univariate and multivariate analyses were conducted for tumor size, number, location, particles size, and use of TFVDS in order to evaluate differences in complete response.
Patients were followed up for a median of 20.1 months, and univariate analysis showed that use of TFDS was the only factor that predicted complete response. However, this predictive factor was not seen on multivariate analysis.
A higher complete response rate was seen for hepatic arterial embolization using TFVDS guidance (68.4%) compared with 2D imaging alone (36%). Additionally, when operators used TFVDS, there was a lower median dose area product (149.7 Gy.cm2, 38-365, vs 227.8 Gy.cm2, 85.3-468.6).
“In conclusion, hepatic arterial embolization using TFVDS may result in better local tumor response than DSA alone for patients with HCC. A prospective validation on a larger scale is now needed before drawing definitive conclusions,” the authors wrote.
Cornelis FH, Borgheresi A, Petre EN, Santos E, Solomon SB, Brown K. Hepatic arterial embolization using cone beam CT with tumor feeding vessel detection software: impact on hepatocellular carcinoma response. Cardiovasc Intervent Radiol. 2018;41(1):104-111.