CT volume measurement for prognostic evaluation of unresectable hepatocellular carcinoma after TACE

Figure 1 Transverse computed tomography (CT) scans showing a mononodular pattern of hepatocellular carcinoma (HCC) in the right posterior lobe of liver and an observed survival time of 33 mo in a 76-year-old man with a tumor volume of 55. 64 cm³ and a tumor to liver volume ratio (TTLVR) of 5.16%. A and B: Arterial phase contrast-enhanced CT scan showing a high density nodule in the right lobe of liver before the fist transcatheter arterial chemoembolization (TACE) procedure, while one-dimensional measurement showing the largest tumor diameter (3.8 cm), and two-dimensional measurement showing the tumor product of the greatest axial dimension (10.64 cm²); C: Contrast-enhanced CT scan showing hepatic and lesion volumetric measurements before the TACE procedure; D: Follow-up CT scan displaying complete tumor necrosis 44 d after the first TACE procedure.

Figure 2 Transverse CT scans showing a massive pattern of HCC in the right lobe of a 46-year-old man with a tumor volume of 1936. 70 cm³, a TTLVR of 67.52%, and a survival time of 6 mo. A and B: Arterial phase contrast- enhanced CT scan showing a high density tumor in the right lobe of liver before the first TACE procedure, while one-dimensional measurement showing the largest tumor diameter (17.7 cm) and two-dimensional measurement showing the tumor product of the greatest axial dimension (237.18 cm²); C: Contrast-enhanced CT scan showing hepatic lesion volumetric measurements before TACE; D: Nonenhanced CT follow-up scan showing lipiodol retention of grade III and a reduced tumor size 60 d after the first TACE procedure.

Figure 3 Cumulative survival time of 166 HCC patients after TACE. The 6 mo- 1-, 2-, 3-, and 5-year cumulative survival rates were 78.92%, 49.85%, 23.82%, 15.60% and 8.92%, respectively, in HCC patients after TACE.

Figure 4 Reverse correlation between survival time and TTLVR values. The TTLVR value was 0%-25%, 25%-50%, 50%-70%, and 70%, respectively.