1Muath A. Alobaid,1Sultan R. Alharbi,

1King Saud University


To illustrate the cone-beam CT and embolization guidance techniques during chemoembolization of HCC.

Material(s) and Method(s):

Hepatocellular carcinoma (HCC) is the most common primary cancer of the liver and the third most common cause of cancer death worldwide. Transarterial chemoembolization (TACE) is the first-line treatment option for intermediate unresectable HCC without vascular invasion or extrahepatic metastasis according to the Barcelona clinic liver cancer (BCLC) staging system. There is huge variation of TACE outcome with median survival range 13-43 months. This variation is partially due to technical variation of TACE therapy. Standardization of TACE technique and vascular mapping of arterial feeding arteries of HCC lead to better response and patient survival. Multiple angiographic runs of hepatic arteries are usually required to identify the arterial feeder of HCC. Cone beam CT is a technique used during TACE to obtain cross-sectional three-dimensional images of the hepatic arteries and delineate the HCC arterial feeder. Volume rendering images of the cone-beam CT are used as embolization guidance of the HCC feeder arteries.


Procedure details: In this educational exhibit, we will present cone beam CT technique in different HCC patients during TACE as well as different embolization guidance technique with different catheter location.


Cone beam CT and embolization guidance techniques are useful during TACE with a tendency to decrease procedure time and contrast.