Objective Measurement of Arterial Flow Before and After Transcatheter Arterial Chemoembolization: A Feasibility Study Using Quantitative Color-Coding Analysis

Purpose To quantitatively measure the hemodynamic change of hepatic artery before and after transcatheter arterial chemoembolization (TACE) of hepatocellular carcinoma (HCC) by quantitative color-coding analysis (QCA). Materials and Methods This prospective study registered 64 consecutive HCC patients who underwent segmental or subsegmental TACE with epirubicin and lipiodol at level 2 or 3 of the subjective angiographic chemoembolization endpoint. QCA was used to determine the maximal density time ( T max ) of selected intravascular region of interest (ROI). Relative T max (r T max ) was defined as the T max at the selected ROI minus the time of contrast medium spurting from the catheter tip. The r T max of hepatic arteries was analyzed before and after embolization. Results The pre- and post-treatment r T max of the landmarks at the treated segmental artery were 1.96 ± 0.48 and 3.14 ± 1.77 s, p < 0.001. According to the treated lobe, 30 patients were treated for the right lobe alone, and 8 patients were treated for the left lobe alone. The pre- and post-r T max of treated segmental artery were 2.06 ± 0.54, 3.34 ± 1.63 s, p < 0.001 and 1.89 ± 0.45, 2.68 ± 1.46 s, p = 0.12, respectively. The r T max of the proximal lobar hepatic arteries or proper hepatic artery had no significant change before and after TACE. Conclusions The QCA is feasible to quantify embolization endpoints by comparing the r T max in selected hepatic arteries before and after TACE. The r T max of treated segmental artery was significant prolonged after optimized procedures.