Usefulness of Combined CTAP and CTHA as a Preoperative Study of Hepatocellular Carcinoma

Korean J Hepatol > Volume 3(4); 1997 > Article

The Korean Journal of Hepatology 1997;3(4): 329-336.

원저 : 간암 환자의 술전 검사로서 CTAP와 CTHA 의 유용성 ( Original Articles : Usefulness of Combined CTAP and CTHA as a Preoperative Study of Hepatocellular Carcinoma )

Usefulness of Combined CTAP and CTHA as a Preoperative Study of Hepatocellular Carcinoma

Suk Ho Lee , Joon Hyoek Lee , Kwang Cheol Koh , Seung Woon Paik , Jong Kyun Lee , Kyu Taek Lee , In Koo Kang , Sung Yun Oh , Poong Lyul Rhee , Jae Jun Kim , Jong Chul Rhee

ABSTRACT

Background/Aims
Combined computed tomography during arterial portography(CfAP) and computed tomography during hepatic arteriography(CBiA) are more sensitive methods compared to conventional spiral CT in detecting small hepatocellular carcinoma. However, there are few data available on the influence of combined CTAP and CTHA on decision making for treatment of hepatocellular carcinoma. We aimed to evaluate the usefulness of CTAP and CfHA as a preoperative study of hepatocellular carcinoma for surgical treatment. Methods: Eighty-two patients with histologically proven hepatocellular carcinoma who were considered to be surgical candidates on spiral CT and angiography were included. CfAP and CTHA were performed as the routine protocol. The findings of CTAP and CTHA were analyzed and compared to conventianal spiral Cl and angiography. Results: 1) 105 nodules were found on spiral Cf plus angiography, whereas, 138 nodules found on combined CIAP and CTHA: 33 additional nodules were found in 23 cases(28%). 2) The treatment plan changed from surgery to nonsurgical treatment in 10(12%) cases: 9 cases(10%) with bilobar involvement, and 1 case (1%) with more than three nodules. 3) The larger the tumor nodules on the spiral CT, the more additional tumor nodules were found on CTAP and CTHA: combined CTAP and CTHA were able to find more nodules in 21% of tumor < 3cm, 27% of tumor with 3 - 10cm, and 71% of tumor >10cm on spiral CI' (p=0.03). Conclusion Compared to spiral CT plus angiography, CI'AP and CfHA may be useful in avoiding unnecessary operation of hepatocellular carcinoma, especially in large tumors. (Korean J Hepatol 1997;7:329 336)

KeyWords: Computed tomography during arterial portography ( CTAP ) , computed tomography during hepatic arteriography ( CTHA ) , Hepatocellular carcinoma , Surgery