Fig. 1CSuccessful identification of tumor feeders of hepatocellular carcinoma (HCC) in the Spiegel lobe (SP). (A) Cone-beam computed tomography (CBCT) studies showed well-differentiated HCC of 23 mm in diameter (arrows) in SP. Approximately 70% of tumor portions showed hypervascularity. (B) Common hepatic arteriogram showed no tumor stains. The caudate artery (A1) was also unclear. The superior lateral subsegmental artery of the left hepatic artery arose from the left gastric artery (not shown). (C) Automated tumor-feeder detection (AFD) identified two tumor feeders arising from the medial subsegmental artery (A4). (D) Selective arteriogram of A4 showed A1 (arrow). (E) Selective arteriogram of A1 showed equivocal tumor staining (arrow). (F) Then two branches were subsequently embolized. The arrows indicate the tumor. Note that AFD mis-traced one tumor-feeder (pink in
). (G) Unenhanced CT performed 1 week after TACE showed dense iodized oil accumulation throughout almost the entire tumor with a sufficient safety margin. Arterial-phase CT performed 3 months after TACE showed the disappearance of SP, and the tumor has remained well-controlled for 5 years and 7 months after TACE. Reprinted from the article of Miyayama et al (Cancers [Basel]. 2021;13:6370).
21 CBCTAP, CBCT during arterioportography; CBCTHA, CBCT during hepatic arteriography.
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