Feasibility of i Flow color-coding technique in quantitative real-time measurement of hemodynamic changes after transarterial chemoembolization for hepatocellular carcinoma / 临床肝胆病杂志

ABSTRACT

Objective To investigate the value of iFlow color-coding technique in quantitative real-time analysis of hemodynamic changes after transarterial chemoembolization (TACE) for hepatocellular carcinoma (HCC) . Methods A total of 31 patients who were diagnosed with HCC in Shanghai Fifth People's Hospital from December 2015 to January 2017 were enrolled. No patient underwent surgical operation or ablation. All patients underwent TACE with the same contrast agent, high-pressure injector parameters, and place of angiographic catheter. The iFlow technique was used to generate two-dimensional color-coded images and time-density curve (TDC) before and after surgery and measure the opening of the angiographic catheter and the time to peak (TTP) of the starting and ending points of the major tumor feeding arteries, as well as the ratio of the areas under the curve (AUC) of TDC of tumor tissue and the opening of the angiographic catheter. The paired t-test was used for comparison of continuous data between groups. Results TTP of the major tumor feeding arteries was 4.64 ± 0. 49 s before TACE and 5. 97 ± 0. 84 s after TACE (t = 11. 57, P ＜ 0. 01), and there was a significant difference in AUC between the tumor tissue and the opening of the angiographic catheter (0. 53 ± 0. 15 vs 0. 16 ± 0. 12, t = 25. 85, P ＜ 0. 01) . There was no significant difference in TTP between the opening of the angiographic catheter and the major tumor feeding arteries before and after TACE (P＞ 0. 05) .Before TACE, the TDC of tumor feeding arteries had a shape of"rapid increase-rapid reduction"with relatively high slope and peak value, while after TACE, the TDC had a shape of "increase-flat-reduction"with reductions in slope and peak value. Conclusion The iFlow technique can perform real-time measurement of TTP and TDC of the region of interest and helps with quantitative evaluation of hemodynamic changes in HCC. Therefore, it can provide objective quantitative indices for evaluating the degree of tumor embolism.