Quantitative assessment of lipiodol deposition after chemoembolization: Comparison between cone-beam CT and multidetector CT

Rongxin Chen, Jean François Geschwind, Zhijun Wang, Vania Tacher, Mingde Lin

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose To evaluate the ability of cone-beam computed tomography (CBCT) performed directly after transarterial chemoembolization to assess ethiodized oil (Lipiodol) deposition in hepatocellular carcinoma (HCC) and compare it with unenhanced multidetector computed tomography (CT). Materials and Methods Conventional transarterial chemoembolization was used to treat 15 patients with HCC, and CBCT was performed to assess Lipiodol deposition directly after transarterial chemoembolization. Unenhanced multidetector CT was performed 24 hours after transarterial chemoembolization. Four patients were excluded because the margin of tumor or area of Lipiodol deposition was unclear. The image enhancement density of the entire tumor and liver parenchyma was measured by ImageJ software, and tumor-to-liver contrast (TLC) was calculated. In addition, volumetric measurement of tumor and Lipiodol was performed by semiautomatic three-dimensional volume segmentation and compared using linear regression to evaluate consistency between the two imaging modalities. Results The mean value of TLC on CBCT was not significantly different from TLC on multidetector CT (337.7 HU ± 233.5 vs 283.0 HU ± 152.1, P =.103).The average volume of the whole tumor and of only the regions with Lipiodol deposition and the calculated average percentage of Lipiodol retention on CBCT were not significantly different compared with multidetector CT (tumor volume, 9.6 cm3 ± 11.8 vs 10.8 cm3 ± 14.2, P =.142; Lipiodol volume, 6.3 cm3 ± 7.7 vs 7.0 cm3 ± 8.1, P =.214; percentage of Lipiodol retention, 68.9% ± 24.0% vs 72.2% ± 23.1%, P =.578). Additionally, there was a high correlation in the volume of tumor and Lipiodol between CBCT and multidetector CT (R2 = 0.919 and 0.903). Conclusions The quantitative image enhancement and volume analyses demonstrate that CBCT is similar to multidetector CT in assessing Lipiodol deposition in HCC after transarterial chemoembolization.

Original languageEnglish (US)
Pages (from-to)1837-1844
Number of pages8
JournalJournal of Vascular and Interventional Radiology
Volume24
Issue number12
DOIs
StatePublished - Dec 2013
Externally publishedYes

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

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