Complete contrast staining of hepatocellular carcinoma during drug-eluting bead chemoembolization predicts a favorable response.

Objective: The objective of this study was to evaluate complete contrast staining (CCS) of HCC during drug-eluting bead transarterial chemoembolization (DEBTACE) first session for response prediction.

Methods: Forty-one patients with solitary HCC who underwent DEBTACE were retrospectively enrolled and divided into two groups based on contrast staining of HCC using two-dimensional (2D) fluoroscopy during the first session of DEBTACE. Both groups underwent one or two sessions of DEBTACE to achieve a complete response. Responses were evaluated using the modified Response Evaluation Criteria in Solid Tumors. A comparison of the complete response between the CCS and non-CCS groups was performed, and the prediction value was studied.

Results: CCS in 2D fluoroscopy during the first session of drug-eluting bead chemoembolization was observed in 22 (53.7%) patients. Well-defined HCC and super-selective chemoembolization were significantly associated with CCS. Complete response was observed in 54.54%, 90%, and 95.45% of CCS patient groups after the first session, second session, and cumulative sessions of TACE, respectively. Complete responses were 10.52%, 29.41%, and 36.84% in the non-CCS group after the first, second, and cumulative sessions of TACE, respectively.

Conclusion: CCS of HCC using 2D fluoroscopy during DEBTACE is a predictor of a favorable response after two sessions of treatment.