COMPARISON OF ANGIOGRAPHY, CT ARTERIOGRAPHY AND MR-IMAGING IN ASSESSMENT OF LIVER METASTASES TREATED BY PERCUTANEOUS TRANSCATHETER INTRAARTERIAL CHEMOTHERAPY

The purpose of this study was to compare results of digital subtractio n angiography (DSA), computed tomographic arteriography (CTA), and mag netic resonance imaging (MRI) in the assessment of patients with liver metastases subjected to percutaneous transcatheter intraarterial chem otherapy. Forty-four patients with liver metastases treated by cyclic percutaneous transcatheter intra-arterial chemotherapy were examined b efore each cycle by an imaging protocol consisting of DSA and CTA. MRI was added to this protocol in 18 patients. DSA and CTA equally detect ed thrombosis of the catheter or arteries distal to the catheter tip i n 16 examinations. DSA detected arterial reflux in 15 examinations, wh ile CTA detected only one case of reflux. CTA was superior to DSA in d emonstrating perfusion abnormalities and superior to MRI in detecting metastases. CT was the only method that demonstrated intratumoral calc ification. In conclusion, in patients with liver metastases subjected to percutaneous transcatheter intra-arterial chemotherapy, DSA is the best method for detection of arterial reflux, whereas CTA is the best method for detection of metastases and demonstration of perfusion abno rmalities.