Hepatocellular carcinoma: Prediction of blood supply from an internal mammary artery with multi-detector row CT

PURPOSE: To retrospectively evaluate the ability of multi-detector row computed tomography (CT) to predict a blood supply from an internal mammary artery in hepatocellular carcinoma (HCC). MATERIALS AND METHODS: Between January 2003 and March 2007, 9,528 transcatheter arterial chemoembolization sessions were performed in 2,815 patients with HCC at the authors' institution. Sixty-three patients (45 men, 18 women; mean age, 61 years) also underwent internal mammary angiography. CT scans and digital subtraction angiograms were retrospectively reviewed by consensus between two authors to evaluate tumor feeding vessels. Univariate analysis and multiple logistic regression analysis were used to identify factors that help predict the presence of a blood supply from an internal mammary artery to HCCs. RESULTS: Tumor staining, supplied by the internal mammary artery, was noted at angiography in 38 of the 63 patients (60%). Readers found that a tumor feeding vessel was present at CT in 30 of these 38 patients (79%) and found no evidence of a tumor feeding vessel at CT in 22 of the 25 patients without a tumor feeding vessel at angiography (88%). A visible feeding vessel at CT (P =.002) and a large tumor size (>5 cm) were found to be significantly related to a blood supply from an internal mammary artery (P =.025). CONCLUSIONS: Multi-detector row CT enables interventional radiologists to predict blood supply from an internal mammary artery by demonstrating most of its tumor feeding vessels.