Multidetector-row computed tomography in the management of hepatocellular carcinoma with transcatheter arterial chemoembolization

Abstract

With the introduction of spiral computed tomography and the development of novel imaging technology in recent years, multidetector-row computed tomography (MDCT) has increasingly been used for the diagnosis of various lesions, especially hepatocellular carcinoma (HCC), due to its volume acquisitions, short scanning time, and especially its double-phase scanning nature, which takes advantage of the dual blood supply of liver. Multidetector-row computed tomography is used to classify HCC into several types based on the blood supply and the histological characteristics of HCC. The evaluation of HCC by MDCT provides crucial clues for the doctors to adopt correct clinical management strategies such as the selection of the appropriate dose of lipiodol before transcatheter arterial chemoembolization (TACE) and the prediction of the prognosis of HCC after TACE. The MDCT scanning allows doctors to choose the region of interest and to evaluate the blood supply according to the lipiodol uptake in order to decide whether there is recrudescence and whether a repeated therapy should be taken. This review describes MDCT, its biphasic scanning, its evaluation of blood supply in HCC and the subsequent classification of HCC, its therapeutic significance before TACE and the prognostic value after TACE. © 2006 Journal of Gastroenterology and Hepatology Foundation and Blackwell Publishing Asia Pty Ltd.