|
1
|
Lanza C, Ascenti V, Amato GV, Pellegrino G, Triggiani S, Tintori J, Intrieri C, Angileri SA, Biondetti P, Carriero S, Torcia P, Ierardi AM, Carrafiello G. All You Need to Know About TACE: A Comprehensive Review of Indications, Techniques, Efficacy, Limits, and Technical Advancement. J Clin Med 2025; 14:314. [PMID: 39860320 PMCID: PMC11766109 DOI: 10.3390/jcm14020314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2024] [Revised: 12/17/2024] [Accepted: 12/28/2024] [Indexed: 01/27/2025] Open
Abstract
Transcatheter arterial chemoembolization (TACE) is a proven and widely accepted treatment option for hepatocellular carcinoma and it is recommended as first-line non-curative therapy for BCLC B/intermediate HCC (preserved liver function, multifocal, no cancer-related symptoms) in patients without vascular involvement. Different types of TACE are available nowadays, including TAE, c-TACE, DEB-TACE, and DSM-TACE, but at present there is insufficient evidence to recommend one TACE technique over another and the choice is left to the operator. This review then aims to provide a comprehensive overview of the current literature on indications, types of procedures, safety, and efficacy of different TACE treatments.
Collapse
Affiliation(s)
- Carolina Lanza
- Department of Diagnostic and Interventional Radiology, Foundation IRCCS Cà Granda—Ospedale Maggiore Policlinico, Via Francesco Sforza 35, 20122 Milan, Italy; (C.L.); (P.B.); (S.C.); (P.T.); (A.M.I.); (G.C.)
| | - Velio Ascenti
- Postgraduate School in Radiodiagnostics, Università degli Studi di Milano, 20122 Milan, Italy; (V.A.); (G.V.A.); (G.P.); (S.T.); (J.T.)
| | - Gaetano Valerio Amato
- Postgraduate School in Radiodiagnostics, Università degli Studi di Milano, 20122 Milan, Italy; (V.A.); (G.V.A.); (G.P.); (S.T.); (J.T.)
| | - Giuseppe Pellegrino
- Postgraduate School in Radiodiagnostics, Università degli Studi di Milano, 20122 Milan, Italy; (V.A.); (G.V.A.); (G.P.); (S.T.); (J.T.)
| | - Sonia Triggiani
- Postgraduate School in Radiodiagnostics, Università degli Studi di Milano, 20122 Milan, Italy; (V.A.); (G.V.A.); (G.P.); (S.T.); (J.T.)
| | - Jacopo Tintori
- Postgraduate School in Radiodiagnostics, Università degli Studi di Milano, 20122 Milan, Italy; (V.A.); (G.V.A.); (G.P.); (S.T.); (J.T.)
| | - Cristina Intrieri
- Postgraduate School in Diangostic Imaging, Università degli Studi di Siena, 20122 Milan, Italy;
| | - Salvatore Alessio Angileri
- Department of Diagnostic and Interventional Radiology, Foundation IRCCS Cà Granda—Ospedale Maggiore Policlinico, Via Francesco Sforza 35, 20122 Milan, Italy; (C.L.); (P.B.); (S.C.); (P.T.); (A.M.I.); (G.C.)
| | - Pierpaolo Biondetti
- Department of Diagnostic and Interventional Radiology, Foundation IRCCS Cà Granda—Ospedale Maggiore Policlinico, Via Francesco Sforza 35, 20122 Milan, Italy; (C.L.); (P.B.); (S.C.); (P.T.); (A.M.I.); (G.C.)
| | - Serena Carriero
- Department of Diagnostic and Interventional Radiology, Foundation IRCCS Cà Granda—Ospedale Maggiore Policlinico, Via Francesco Sforza 35, 20122 Milan, Italy; (C.L.); (P.B.); (S.C.); (P.T.); (A.M.I.); (G.C.)
| | - Pierluca Torcia
- Department of Diagnostic and Interventional Radiology, Foundation IRCCS Cà Granda—Ospedale Maggiore Policlinico, Via Francesco Sforza 35, 20122 Milan, Italy; (C.L.); (P.B.); (S.C.); (P.T.); (A.M.I.); (G.C.)
| | - Anna Maria Ierardi
- Department of Diagnostic and Interventional Radiology, Foundation IRCCS Cà Granda—Ospedale Maggiore Policlinico, Via Francesco Sforza 35, 20122 Milan, Italy; (C.L.); (P.B.); (S.C.); (P.T.); (A.M.I.); (G.C.)
| | - Gianpaolo Carrafiello
- Department of Diagnostic and Interventional Radiology, Foundation IRCCS Cà Granda—Ospedale Maggiore Policlinico, Via Francesco Sforza 35, 20122 Milan, Italy; (C.L.); (P.B.); (S.C.); (P.T.); (A.M.I.); (G.C.)
- Faculty of Health Science, Università degli Studi di Milano, Via Festa del Perdono 7, 20122 Milan, Italy
| |
Collapse
|
|
2
|
Zandieh G, Yazdaninia I, Afyouni S, Shaghaghi M, Borhani A, Mohseni A, Shaghaghi S, Liddell R, Kamel IR. Spectrum of Imaging Findings and Complications After Hepatic Transarterial Chemoembolization for Liver Tumors. J Comput Assist Tomogr 2024; 48:701-712. [PMID: 38595176 DOI: 10.1097/rct.0000000000001610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/11/2024]
Abstract
ABSTRACT This study reviews the spectrum of imaging findings and complications after transarterial chemoembolization (TACE) for the treatment of primary liver tumors (hepatocellular carcinoma, cholangiocarcinoma) and liver metastases. The review encompasses a spectrum of imaging criteria for assessing treatment response, including the modified Response Evaluation Criteria in Solid Tumors guidelines, tumor enhancement, and apparent diffusion coefficient alterations.We discuss the expected posttreatment changes and imaging responses to TACE, describing favorable and poor responses. Moreover, we present cases that demonstrate potential complications post-TACE, including biloma formation, acute cholecystitis, abscesses, duodenal perforation, arterial injury, and nontarget embolization. Each complication is described in detail, considering its causes, risk factors, clinical presentation, and imaging characteristics.To illustrate these findings, a series of clinical cases is presented, featuring diverse imaging modalities including computed tomography, magnetic resonance imaging, and digital subtraction angiography.
Collapse
Affiliation(s)
- Ghazal Zandieh
- From the Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins Medicine, John's Hopkins University, Baltimore, MD
| | - Iman Yazdaninia
- From the Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins Medicine, John's Hopkins University, Baltimore, MD
| | - Shadi Afyouni
- From the Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins Medicine, John's Hopkins University, Baltimore, MD
| | - Mohamadreza Shaghaghi
- From the Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins Medicine, John's Hopkins University, Baltimore, MD
| | - Ali Borhani
- From the Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins Medicine, John's Hopkins University, Baltimore, MD
| | - Alireza Mohseni
- From the Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins Medicine, John's Hopkins University, Baltimore, MD
| | - Shiva Shaghaghi
- Department of Radiology, University of Pennsylvania, Philadelphia, PA
| | - Robert Liddell
- Division of Vascular and Interventional Radiology, Russell H. Morgan Department of Radiology and Radiological Sciences, The Johns Hopkins Hospital, Baltimore, MD
| | - Ihab R Kamel
- From the Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins Medicine, John's Hopkins University, Baltimore, MD
| |
Collapse
|