Efficacy of cone-beam computed tomography and guidance software in transarterial chemoembolization for hepatocellular carcinoma

Advances in C-arm angiography equipped with flat panel detectors have enabled cone-beam computed tomography (CBCT) to reconstruct images from rotational data of the patient. Notably, this technique is now applied to assist transarterial chemoembolization (TACE) for hepatocellular carcinoma (HCC). CBCT exhibits significantly greater sensitivity than digital subtraction angiography in detecting tumors and tumor feeders during procedures. Additionally, CBCT can reduce local tumor progression following TACE and prolong the lifespan of patients with HCC. Moreover, TACE guidance software, with three-dimensional vessel-tracking and virtual parenchymal perfusion functionalities, reduces operator workload, readily facilitates procedural simulation, and enhances TACE accuracy. Therefore, CBCT and its associated technologies may improve the therapeutic efficacy of TACE in patients with HCC. • CBCT has a higher sensitivity to detect HCC than DSA and MDCT, especially HCC ≤2 ​cm. • CBCT and AFD can correctly identify the more tumor feeders in shorter time than DSA. • CBCT-assisted TACE can reduce LTP of HCC and prolong the lifespan of HCC patients. • TACE guidance software can improve the accuracy of TACE and innovate its workflow.