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Background: Trans-catheter arterial chemoembolization is one of the effective therapeutic options for hepatocellular carcinoma (HCC). Ultra-selective chemoembolization is an approach improving the local control, and is associated with a reduced incidence of adverse effects. Aim of Study: It was to evaluate the sensitivity of cone beam computed tomography (CBCT) in detecting HCC tumors and their feeding vessels during trans-arterial chemoembolization (TACE). Patients and Methods: All patients were suspected of having or confirmed to have HCC based on clinical history, underlying liver disease and/or viral infection, the diagnosis of HCC was made by imaging findings. Between January 2018 and January 2019, the prototype chemoembolization guidance software for syngo Dyna CT was retrospectively used in 25 consecutive patients with HCC tumor. Results: The detectability of the tumor with non-selective DSA obtained at the common, proper, right, or left hepatic arteries and compared to cone-beam CT. The tumor stain and feeding branches were evaluated. Detectability of the tumorfeeding branch with non-selective DSA and Dyna CT analyzing the first CT HA images was compared. Tumor detectability on cone-beam CT was significantly greater than on nonselective. Cone beam HA could depict (91.5%) of tumors. Nonselective DSA could depict only (72.1%). Cone-beam CT has satisfactory ability to detect tumors; could identify 81% of tumor-feeding branches at the level of the subsub segmental artery of the hepatic artery in HCC lesions. Conclusion: The technical success rates of ultraselective transcatheter arterial chemoembolization may be improved by chemoembolization guidance software that uses cone-beam CT technology.

Improving Hepatocellular Carcinoma (HCC) Detectability Using Cone Beam CT (CBCT) During Transarterial Chemo-Embolization (TACE)