IR Playbook pp 381-387 | Cite as

Transarterial Chemoembolization

  • Paul Haste
  • Matthew S. JohnsonEmail author


Primary liver cancer is one of the most frequently diagnosed malignancies worldwide and is the second leading cause of cancer death. Approximately 70–90% of primary liver cancer is hepatocellular carcinoma (HCC). HCC most often occurs in the setting of chronic liver disease/cirrhosis.

It is important to screen these patients with surveillance imaging because of the increased risk of HCC in patients with cirrhosis. HCC has characteristic features on CT/MRI: arterial phase enhancement and portal venous/delayed phase washout. Multiple staging systems exist for patients with HCC; the most common in the western world is the Barcelona Clinic Liver Cancer (BCLC) staging system. It provides treatment recommendations based upon tumor burden, patient’s clinical status, and lab values.

A multidisciplinary approach is recommended for determining treatment and follow-up of these complex patients. Conventional therapies include potentially curative surgical resection and transplant. These options are limited by staging, tumor burden, and performance status. Transarterial embolization (TAE) and chemoembolization (TACE) are IR treatments wherein embolic agents with or without chemotherapy are injected directly into the arteries supplying the tumors. The agents are often mixed with iodized oil (cTACE) or drug-eluting embolics (DEE-TACE).


Hepatocellular carcinoma Cirrhosis Li-RADS Liver transplant Transarterial chemoembolization Arteriography 


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© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of RadiologyIndiana University School of MedicineIndianapolisUSA
  2. 2.Department of Radiology and Imaging SciencesIndiana University School of MedicineIndianapolisUSA

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