Fig. 4. Grade B technical success of TACE despite successful identification of tumor feeders of hepatocellular carcinoma (HCC) in the paracaval portion (PC). (A) Arterial-phase computed tomography (CT) showed HCC of 20 mm in diameter in PC (arrow). A small tumor was also revealed in segment 5 (S5) (not shown). (B) Common hepatic arteriogram showed tumor staining (arrow). (C) Automated tumor-feeder detection could identify two tumor feeders arising from the anterior segmental artery of the right hepatic artery and middle hepatic artery. The feeder supplying the small tumor in S5 was also identified. (D) The tumor feeders were subsequently embolized. The arrows indicate the tumor. (E) Unenhanced CT performed 1 week after TACE showed that the entire tumor was embolized but the safety margin was not obtained in some tumor parts. A small amount of right pleural effusion was also seen. (F) Arterial-phase CT performed 2 months after TACE showed complete tumor response. (G) However, arterial-phase CT performed 17 months after TACE showed the recurrent tumor (arrow) adjacent to the iodized oil accumulated tumor (arrowhead).
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