CT spectrum of findings in liver parenchyma after transarterial chemoembolization with DC-beads

Purpose To describe MDCT findings and parenchymal changes after transarterial chemoembolization (TACE) with DC-beads in the treatment of primary and metastasic liver tumors. Materials and Methods Baseline and follow-up CT scans obtained in 93 patients with TACE DC-bead treatment between September 2009 and March 2012 were reviewed retrospectively to evaluate changes in biliary ducts, adjacent portal vein branches and hepatic parenchyma. Clinical data including etiology and correlation with CT findings were analyzed using the Fischer test. A p Results 93 patients, 55 men and 38 women (21-78 years) were evaluated. Etiologies included 44 hepatocellular carcinomas (38 with cirrhosis), 17 neuroendocrine metastases, 10 colorectal metastases and 22 others. The average time between TACE and follow-up CT was 50 days (r6-172). The most frequent findings at follow-up were bile duct dilatation (41.9%, n 39), obliteration of adjacent intrahepatic portal vein branches (31.1%, n 29), bilomas (26.8%, n 25), parenchymal hypodense ill-defined areas (44%, n 41), parenchymal infarcts (6.4%, n 6), periportal edema (35.4%, n 33) and perilesional parenchymal enhancement (23.6%, n 22). One patient (1.07%) had an abscess. The first 4 findings showed significant negative association with cirrhosis. In spite of these findings, there were no clinical relevant manifestations in these patients. There were no mayor complications reported. Only one patient required a percutaneous drainage catheter to drain an abscess. Conclusion The spectrum of MDCT findings we report after transarterial chemoembolization with DC-beads were not related with clinical manifestations of mayor complications in most cases. It is important for the radiologist to be familiar with these changes in order to distinguish collateral findings from complications and residual or recurrent tumor.