We investigated the efficacy of dual-phase CT arteriography (DCTA) of the liver in the prediction of the effectiveness of transcatheter arterial chemoembolization (TACE) in hepatocellular carcinoma (HCC). DCTA images were obtained in the early and delayed phases during hepatic arteriography in 35 patients receiving TACE and follow-up studies. DCTA was done in 84 HCCs, and the findings of 46 TACE effective HCCs and 38 TACE ineffective HCCs were retrospectively analyzed. All HCCs were evaluated radiologically. All TACE effective HCCs and 24 of 38 TACE ineffective HCCs were hypervascular and showed high attenuation (H) in the early phase. In the combination with the early and delayed phase, 42 of 46 TACE effective HCCs showed H in the early phase and ring-like stain (R) in the delayed phase, while only 2 of 38 TACE ineffective HCCs showed this combination. When the combination of H in the early phase and R in the delayed phase was used as the criterion for TACE effective HCC, sensitivity, specificity, and positive predictive value were 91%, 95%, and 95%, respectively. We concluded that H in the early phase and R in the delayed phase on DCTA was a highly characteristic pattern indicating TACE effective HCC. The present study suggests that DCTA is a useful method to predict the effectiveness of TACE in HCCs.

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This study was conducted to evaluate the feasibility and effectiveness of transcatheter arterial embolization (TAE) using degradable starch microspheres (DSM) against hepatocellular carcinoma (HCC). Six HCC patients with previously untreated tumors were enrolled in this study. After DSM-TAE, objective response was evaluated by dynamic computed tomography according to Liver Cancer Study Group of Japan criteria. Thereafter, one patient received hepatectomy and the remaining 5 received DSM-TAE with epirubicin (DSM-TACE). Only side effect was transient abdominal pain, which was seen in all patients. Of the 6 patients, 3 achieved a PR, 2 showed a MR, and one showed NC. Of 4 patients evaluable for response to DSM-TACE, 2 achieved a CR, and 2 showed a PR. These promising results encouraged us to promote a multicenter trial of evaluating the efficacy of DSM-TACE.

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[in Japanese]

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[in Japanese]

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[in Japanese]

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[in Japanese]

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