Tesi di specializzazione (5 anni)
Benign peritumoral arterial enhancement after DEB-TACE of HCC.
RICERCA TRASLAZIONALE E DELLE NUOVE TECNOLOGIE IN MEDICINA E CHIRURGIA
Corso di studi
relatore Prof. Bartolozzi, Carlo
- peritumoral arterial enhancement
Data inizio appello
Abstract <br>Purpose: To evaluate incidence and clinical significance of peritumoral contrast enhancement found at CT one month after drug-eluting beads transarterial chemoembolization (DEB-TACE) of hepatocellular carcinoma (HCC).<br>Materials and Materials: Data were collected of all consecutive naïve HCC patients treated with DEB-TACE between February 2008 and September 2013 with reported complete radiological response at one-month follow-up according to modified Response Evaluation Criteria for Solid Tumors (mRECIST). Patients with <90 days post-TACE follow-up were excluded. One-month CT examinations were retrospectively reviewed to assess the presence of a peritumoral rim of contrast enhancement, with the following features: 1-2 mm in size, concentric, symmetric, homogeneously hyper-attenuating in the arterial phase and hyper- or iso-attenuating in the portal venous and equilibrium phases. On follow-up, local tumor recurrence was recorded. Time to local progression was calculated with Kaplan-Meier method and curves were compared with log-rank test.<br>Results: The final study population consisted of 114 patients (M/F: 89/25; mean age 63.9 ± 10.8 years) with 129 HCC lesions (mean diameter 27.1 ± 12.5 mm). At 1-month CT follow-up, a peri-tumoral rim of enhancement was identified in 49 lesions (38%). Compared to nodules without rim of enhancement, they resulted to be significantly larger (mean diameter 31.3±12.6 mm versus 24.5±11.7 mm, P=.0024) and with a pre-procedural pseudocapsule (P=.0007).