Skip to main content
SpringerLink
Log in

Iodized oil accumulation in the hypovascular tumor portion of early-stage hepatocellular carcinoma after ultraselective transcatheter arterial chemoembolization

  • Original Research
  • Published:
Hepatology International Aims and scope Submit manuscript

Abstract

Purpose

We evaluated iodized oil accumulation in the hypovascular portion of early-stage hepatocellular carcinoma (HCC) after ultraselective transcatheter arterial embolization (TACE).

Materials and methods

Forty-seven HCC lesions with hypovascular portions were treated by TACE at the distal level of the sub-subsegmental artery of the liver. Portal blood in the hypovascular portion was classed in two grades by computed tomography (CT) during arterial portography: decreased and preserved. Iodized oil accumulation was classed into three grades on CT obtained 1 week after TACE: (1) dense accumulation in the almost entire tumor, including the hypovascular portion (grade 2); (2) dense accumulation in hypervascular portions but sparse accumulation in hypovascular portion (grade 1); and (3) sparse accumulation or no accumulation (grade 0). Findings on serial follow-up CT images were also analyzed.

Results

Portal blood in the hypovascular portion was decreased in 32 lesions, and preserved in 15 lesions. On CT 1 week after TACE, 32 tumors (68.1%)—23 with decreased portal blood and 9 with preserved portal blood—were classed as grade 2. Twelve tumors (25.5%), six with decreased portal blood and six with preserved portal blood, were classed as grade 1. Three tumors (6.4%) with decreased portal blood were classed into grade 0. In total, 25 tumors (53.2%), 22 in grade 2 and 3 in grade 1, were well controlled by ultraselective TACE during the mean follow-up of 15.8 months.

Conclusions

Iodized oil accumulation and retention in the hypovascular portion of early-stage HCC was frequently observed after ultraselective TACE, mainly in the hypovascular portion with decreased portal blood.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Sakamoto M, Hirohashi S, Shimosato Y. Early stages of multistep hepatocarcinogenesis: adenomatous hyperplasia and early hepatocellular carcinoma. Hum Pathol 1991;22:172–8.

    Article  PubMed  CAS  Google Scholar 

  2. Matsui O, Kadoya M, Kameyama T, Yoshikawa J, Takashima T, Nakanuma Y, et al. Benign and malignant nodules in cirrhotic livers: distinction based on blood supply. Radiology 1991;178:493–7.

    PubMed  CAS  Google Scholar 

  3. Choi BI, Takayasu K, Han MC. Small hepatocellular carcinomas and associated nodular lesions of the liver: pathology, pathogenesis, and imaging findings. Am J Roentgenol 1993;160:1177–87.

    CAS  Google Scholar 

  4. Hayashi M, Matsui O, Ueda K, Kwamori Y, Kadoya M, Yoshikawa J, et al. Correlation between the blood supply and grade of malignancy of hepatocellular nodules associated with liver cirrhosis: evaluation by CT during intraarterial injection of contrast medium. Am J Roentgenol 1999;172:969–76.

    CAS  Google Scholar 

  5. Hayashi M, Matsui O, Ueda K, Kawamori Y, Gabata T, Kadoya M. Progression to hypervascular hepatocellular carcinoma: correlation with intranodular blood supply evaluated with CT during intraarterial injection of contrast material. Radiology 2002;225:143–9.

    Article  PubMed  Google Scholar 

  6. Honda H, Tajima T, Kajiyama K, Kuroiwa T, Yoshimitsu K, Irie H, et al. Vascular changes in hepatocellular carcinoma: correlation of radiologic and pathologic findings. Am J Roentgenol 1999;173:1213–7.

    CAS  Google Scholar 

  7. Takayasu K, Wakao F, Moriyama N, Muramatsu Y, Sakamoto M, Hirohashi S, et al. Response of early-stage hepatocellular carcinoma and borderline lesions to therapeutic arterial embolization. Am J Roentgenol 1993;160:301–6.

    CAS  Google Scholar 

  8. Ueda K, Saito K, Terada T, Nakanuma Y. Selective necrosis of encapsulated malignant lesion within atypical adenomatous hyperplasia of the liver following transarterial embolization: a report of two autopsy cases. J Clin Gastroenterol 1991;13:709–14.

    Article  PubMed  CAS  Google Scholar 

  9. Miyayama S, Matsui O, Yamashiro M, Ryu Y, Kaito K, Ozaki K, et al. Ultraselective transcatheter arterial chemoembolization using a 2-F tip microcatheter for small hepatocellular carcinomas: relationship between local tumor recurrence and visualization of the portal vein by iodized oil. J Vasc Interv Radiol 2007;18:365–76.

    Article  PubMed  Google Scholar 

  10. Yamada R, Sato M, Kawabata M, Nakatsuka H, Nakamura K, Takashima S. Hepatic artery embolization in 120 patients with unresectable hepatoma. Radiology 1983;148:397–401.

    PubMed  CAS  Google Scholar 

  11. Uchida H, Ohishi H, Matsuo N, Nishimine K, Ohue S, Nishimura Y, et al. Transcatheter hepatic segmental arterial embolization using Lipiodol mixed with an anticancer drug and Gelfoam particles for hepatocellular carcinoma. Cardiovasc Intervent Radiol 1990;13:140–5.

    Article  PubMed  CAS  Google Scholar 

  12. Matsui O, Kadoya M, Yoshikawa J, Gabata T, Arai K, Demachi H, et al. Small hepatocellular carcinoma: treatment with subsegmental transcatheter arterial embolization. Radiology 1993;188:79–83.

    PubMed  CAS  Google Scholar 

  13. Takayasu K, Muramatsu Y, Maeda T, Iwata R, Furukawa H, Muramatsu Y, et al. Targeted transarterial oily chemoembolization for small foci of hepatocellular carcinoma using a unified helical CT and angiography system: analysis of factors affecting local recurrence and survival rates. Am J Roentgenol 2001;176:681–8.

    CAS  Google Scholar 

  14. Miyayama S, Matsui O, Taki K, Minami T, Ryu Y, Ito C, et al. Arterial blood supply to the posterior aspect of segment IV of the liver from the caudate branch: demonstration at CT after iodized oil injection. Radiology 2005;237:1110–4.

    Article  PubMed  Google Scholar 

  15. Nakamura H, Hashimoto T, Oi H, Sawada S. Iodized oil in the portal vein after arterial embolization. Radiology 1988;167:415–7.

    PubMed  CAS  Google Scholar 

  16. Terayama N, Matsui O, Gabata T, Kobayashi S, Sanada J, Ueda K, et al. Accumulation of iodized oil within the non-neoplastic liver adjacent to hepatocellular carcinoma via the drainage routes of the tumor after transcatheter arterial embolization. Cardiovasc Intervent Radiol 2001;24:383–7.

    Article  PubMed  CAS  Google Scholar 

  17. Miyayama S, Matsui O, Yamashiro M, Ryu Y, Takata H, Takeda T, et al. Detection of hepatocellular carcinoma by CT during arterial portography using a cone-beam CT technology: comparison with conventional CTAP. Abdom Imaging 2007; in press.

  18. Llovet JM, Vilana R, Bru C, Bianchi L, Salmeron JM, Boix L, et al. Increased risk of tumor seeding after percutaneous radiofrequency ablation for single hepatocellular carcinoma. Hepatology 2001;33:1124–9.

    Article  PubMed  CAS  Google Scholar 

  19. McGahan JP, Dodd GD III. Radiofrequency ablation of the liver: current status. Am J Roentgenol 2001;176:3–16.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Diagnostic Radiology, Fukuiken Saiseikai Hospital, 7-1, Funabashi, Wadanaka-cho, Fukui, 918-8503, Japan

    Shiro Miyayama, Masashi Yamashiro, Yasuji Ryu, Harumi Takata, Taro Takeda, Hiroyuki Aburano & Noriaki Shigenari

  2. Department of Radiology, Graduate School of Medical Science, Kanazawa University, 13-1, Takara-machi, Kanazawa, 920-8641, Japan

    Osamu Matsui

Authors
  1. Shiro Miyayama
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Osamu Matsui
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Masashi Yamashiro
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Yasuji Ryu
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Harumi Takata
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Taro Takeda
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Hiroyuki Aburano
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Noriaki Shigenari
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Shiro Miyayama.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Miyayama, S., Matsui, O., Yamashiro, M. et al. Iodized oil accumulation in the hypovascular tumor portion of early-stage hepatocellular carcinoma after ultraselective transcatheter arterial chemoembolization. Hepatol Int 1, 451–459 (2007). https://doi.org/10.1007/s12072-007-9030-5

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12072-007-9030-5

Keywords

Search

Navigation