Background: This study aims to evaluate immediate changes in perfusion parameters in hepatocellular carcinoma\n(HCC) to transarterial chemoembolization (TACE) in C-arm computed tomography (CT) and volume perfusion CT\n(VPCT) and prediction of midterm tumor response.\nMethods: Twenty-five patients (median age 66, range 61 to 75 years) with 62 HCC lesions undergoing TACE\nreceived immediate pre- and post-interventional assessment by C-arm CT and VPCT. Cross-sectional imaging was\nanalyzed at baseline and approximately 12 weeks after TACE according to modified RECIST criteria. Outcome was\ndefined as objective response (OR, > 30 % reduction of viable tumor) or non-OR. Perfusion parameters were\nevaluated in C-arm CT [parenchymal blood volume (PBV)] and VPCT [blood volume (BV) and blood flow (BF)]. Ratios\nof perfusion parameters before and after TACE within the tumor and the non-affected liver parenchyma were\ncalculated.\nResults: Correlation between tumor PBV and BV revealed a moderate correlation (rho = 0.45, p = 0.005). In nonaffected\nliver parenchyma, a significant decrease in PBV was seen, compared to a significant increase in BF and BV.\nPerfusion ratios in HCC lesions were significantly (p < 0.05) increased in OR group compared to non-OR patients in\nC-arm CT and VPCT: PBV ratio (0.95 (0.06) to 0.67 (0.38), BV ratio 0.63 (0.34) to 0.15 (0.6), and BF ratio 0.6 (0.32) to 0.\n22 (0.51). Logistic regression including PBV and BF allowed prediction of OR (sensitivity 88 %/specificity of 83 %).\nConclusions: Perfusion parameters acquired by C-arm CT and VPCT cannot simply be substituted by each other,\nbut show similar capability in prediction of midterm tumor response.
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