Occurrence of Vascular Lake Phenomenon Before Embolization for the Prediction of Lipiodol Uptake for Intermediate-Stage
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CLINICAL INVESTIGATION
INTERVENTIONAL ONCOLOGY
Occurrence of Vascular Lake Phenomenon Before Embolization for the Prediction of Lipiodol Uptake for Intermediate-Stage Hepatocellular Carcinoma Patients that Underwent cTACE Bo Hu1 • Bin-yan Zhong1 • Lei Zhang1 • Chen Dai2 • Wei Li1 • Jian Shen1 Peng Huang1 • Shen Zhang1 • Zhi Li1 • Cai-fang Ni1
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Received: 22 November 2019 / Accepted: 18 April 2020 Springer Science+Business Media, LLC, part of Springer Nature and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE) 2020
Abstract Purpose To compare Lipiodol uptake and tumor response in intermediate-stage hepatocellular carcinoma (HCC) with and without pre-embolization vascular lake phenomenon (VLP) and to identify the incidence and predictive factors of this phenomenon, in patients treated by conventional transarterial chemoembolization (cTACE). Materials and Methods This retrospective study included 151 consecutive patients with intermediate HCC totaling 232 nodules, who underwent cTACE from June 2015 to October 2018. Patients were divided into two groups according to the presence of VLP before embolization. Initial Lipiodol uptake was assessed using post-cTACE computed tomography (CT) within 1–1.5 months after cTACE. Enhanced CT or magnetic resonance imaging was performed at 6 months after the procedure to assess local recurrence and distant metastasis.
Bo Hu and Bin-yan Zhong have contributed equally as joint first authors.
Results The VLP was demonstrated in 21.85% (33/151) patients and 16.81% (39/232) nodules on the super-selective angiography. On nodule-based analysis, significantly better Lipiodol uptake (p \ 0.001) and higher ORR (60.61% vs. 26.49%, p \ 0.001) and DCR (87.88% vs. 51.66%, p \ 0.001) were observed in the VLP group compared to the non-VLP group. The multivariate logistic regression analysis showed that the presence of VLP (OR 6.431, 95% CI 2.495–16.579) might be a predictive factor for better Lipiodol uptake. Univariate and multivariate logistic regression analysis showed that poor differentiation of tumor (OR 6.397, 95% CI 2.804–19.635) remained predictive for the VLP. Conclusion The incidence of VLP before embolization is 21.19%. The presence of VLP is well correlated with tumor Lipiodol uptake after cTACE and may be a new predictive factor for evaluation of cTACE efficacy and prognosis of intermediate HCC. Keywords Vascular lake phenomenon Transarterial chemoembolization Hepatocellular carcinoma Lipiodol uptake Prognosis
Cai-fang Ni and Zhi Li have contributed equally as joint corresponding authors. & Zhi Li [email protected] & Cai-fang Ni [email protected] 1
Department of Interventional Radiology, The First Affiliated Hospital of Soochow University, No. 188, Shizi Street, Suzhou 215006, China
2
Department of General Surgical, The First Affiliated Hospital of Soochow University, No. 188, Shizi Street, Suzhou 215006, China
Introduction Conventional transarterial chemoembolization (cTACE), which combines the cytotoxic and ischemic effe
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