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  • Title: Chemoembolization via the left internal mammary artery supplying hepatocellular carcinoma.
    Author: Kim SH, Kim HC, Hur S, Lee M, Jung HS, Jae HJ, Chung JW.
    Journal: J Vasc Interv Radiol; 2014 Sep; 25(9):1389-97.e1. PubMed ID: 25070775.
    Abstract:
    PURPOSE: To present radiologic findings that show favorable tumor response after chemoembolization via the left internal mammary artery (LIMA). MATERIALS AND METHODS: Between October 2002 and April 2013, 57 patients with hepatocellular carcinoma (HCC) underwent 69 sessions of chemoembolization via the LIMA. Imaging findings including tumor size, location, and visibility of tumor-feeding artery on cross-sectional images were retrospectively reviewed in consensus by two radiologists. Tumor response after chemoembolization via the LIMA was assessed by the modified Response Evaluation Criteria in Solid Tumors on follow-up multidetector computed tomography in consensus. RESULTS: The mean tumor size supplied by the LIMA was 6.8 cm (range, 1.0-21.0 cm). HCCs supplied by the LIMA tended to be located in the subcapsular area including exophytic features (57 of 57; 100%) and were more likely to be located in the left lobe of the liver (56 of 57; 98%). HCCs supplied by the LIMA were more likely to be multiple or infiltrative (52 of 57; 91%) and marginally recurred (43 of 57; 75%). Feeding arteries of the LIMA were identified in a high percentage of cases (49 of 66; 74%) on cross-sectional images obtained before embolization. Regarding tumor response, tumors that were newly developed or exclusively supplied by the LIMA showed better target tumor response (P = .011 and P < .0001, respectively). On multivariate analysis, tumors exclusively supplied by the LIMA showed significantly better target tumor response with odds ratio of 16.32. CONCLUSIONS: Chemoembolization via the LIMA has a favorable target tumor response when HCCs are exclusively supplied by the LIMA.
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