Introduction: The aim of this study was to investigate the technical success rate of obtaining 3D-safety margin in superselective conventional transarterial chemoembolization (cTACE) using 3D images for small hepatocellular carcinoma (HCC). Methods: Consecutive 48 HCC nodules (diameter, 1–3 cm) in 44 patients were intentionally treated by superselective cTACE in an attempt to achieve 3D-safety margin. Superselective CT during hepatic arteriography (CTHA) was obtained before cTACE. When negative 3D-safety margin was found, branches supplied into the margin area were detected by using a 3D workstation. The technical success rate to obtain 3D-safety margin was investigated by intend-to-treat analysis. Local tumor recurrence rate and adverse events were also evaluated. Result: Nine of 48 tumors (18.8%) had 3D-safety margin in the initial superselective CTHA. After pulling back of the catheter and/or selection of another branch based on 3D images, 3D-safety margin was finally achieved in 45 (93.8%). There were 8 of 46 tumors (17.4%) with local recurrence after 5-year follow-up. Grade 3–4 of aspartate aminotransferase, alanine aminotransferase, and total bilirubin were found in 38.6, 36.4, and 2.3%, respectively. One portal vein thrombus and 3 biliary dilation or biloma were developed. Conclusion: Superselective cTACE obtaining 3D-safety margin in small HCC was feasible with a high success rate by using 3D images, which could be tolerable and prevent local tumor recurrence.
Liver Cancer

中文翻译：

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在超选择性经动脉化疗栓塞术中确保 3D 安全裕度以改善小肝细胞癌局部肿瘤控制的可行性和技术：意向治疗分析

简介：本研究的目的是调查使用 3D 图像治疗小肝细胞癌 (HCC) 在超选择性常规经动脉化疗栓塞 (cTACE) 中获得 3D 安全边缘的技术成功率。方法： 44 名患者的连续 48 个 HCC 结节（直径，1-3 cm）接受超选择性 cTACE 治疗，以达到 3D 安全边界。在 cTACE 之前获得肝动脉造影期间的超选择性 CT (CTHA)。当发现负 3D 安全边际时，使用 3D 工作站检测供应到边缘区域的分支。通过意向治疗分析调查获得 3D 安全边际的技术成功率。还评估了局部肿瘤复发率和不良事件。结果：48 个肿瘤中有 9 个（18.8%）在初始超选择性 CTHA 中具有 3D 安全边界。在拉回导管和/或基于 3D 图像选择另一个分支后，最终在 45 例 (93.8%) 中实现了 3D 安全边界。5 年随访后，46 例肿瘤中有 8 例（17.4%）局部复发。天冬氨酸氨基转移酶、丙氨酸氨基转移酶和总胆红素的 3-4 级分别为 38.6%、36.4% 和 2.3%。1 个门静脉血栓和 3 个胆管扩张或胆汁瘤。结论：超选择性cTACE在小肝癌中获得3D安全边缘是可行的，利用3D图像获得高成功率，可耐受并预防局部肿瘤复发。
肝癌