LIPIODOL RETENTION AND MASSIVE NECROSIS AFTER LIPIODOL-CHEMOEMBOLIZATION OF HEPATOCELLULAR-CARCINOMA - CORRELATION BETWEEN COMPUTED-TOMOGRAPHY AND HISTOPATHOLOGY

This retrospective study examined the computed tomography (CT) criteri a for judging the effectiveness of transcatheter arterial Lipiodol-che moembolization (Lp-chemo-TAE) in 35 cases with hepatocellular carcinom a (HCC). Massive necrosis, defined as involving 97% or more of the HCC nodule, was observed in 15 cases after Lp-chemo-TAE, whereas nonmassi ve necrosis, defined as involving less-than-or-equal-to 96% of the HCC nodule, was observed in the remaining 20 cases. In 12 of 15 cases (80 %) with massive necrosis, uniform dense retention of Lipiodol (Lp) was observed throughout the HCC nodule on CT images 3-4 weeks after Lp-ch emo-TAE as opposed to only one (5%) of 20 cases with nonmassive necros is (p < 0.01). Eight of nine cases (89%) with massive necrosis had tum or attentuation values of 365 Hounsfield units (HU) or greater on CT i mages 3-4 weeks after embolization, as opposed to only four (27%) of 1 5 cases with nonmassive necrosis (p < 0.01). We conclude that the effe ctiveness of the Lp-chemo-TAE can be judged on CT from the degree and duration of Lp retention in the HCC nodule and the measurement of the attenuation value of the HCC nodule.