Extra-hepatic feeding arteries of hepatocellular carcinoma: An investigation based on intra-arterial CT aortography images using an angio-MDCT system

•We investigated the frequencies and factors associated with the presence of extrahepatic feeding arteries of hepatocellular carcinoma using intraarterial CT aortography images.•Repeat transarterial chemoembolization procedures and tumor size were independent risk factors for the presence of extrahepatic feeding arteries of hepatocellular carcinoma.

ObjectivesWe investigated the frequencies and factors associated with the presence of extra-hepatic feeding arteries (EHFAs) of hepatocellular carcinoma (HCC) using intra-arterial CT aortography images.MethodsA total of 173 patients with HCC who underwent transarterial chemoembolization (TACE) in our institution between January 2013 and March 2015 were enrolled. The types of EHFAs were evaluated by CT aortography images using an apparatus that combines multidetector-row computed tomography and angiography system. In addition, factors associated with the presence of EHFAs were determined.ResultsEHFAs were present in 22 (12.7%) patients with HCC. EHFAs most frequently branched from the right inferior phrenic artery (n = 19), while others branched from the right adrenal artery (n = 2), right renal artery (n = 2), right internal thoracic artery (n = 2), branches of the superior mesenteric artery (n = 1), and an unknown artery from the aorta (n = 1). Factors significantly associated with the presence of EHFAs in multivariate analysis were tumor size ≥ 30 mm (odds ratio (OR), 5.233 [95% confidence interval (CI), 1.507-17.413]; p = 0.009) and number of prior TACE treatments ≥ 3 (OR, 6.847 [95% CI, 1.928-24.311]; p = 0.003).ConclusionsEHFAs of HCC were assessed with CT aortography images. Repeat TACE treatments and large tumor size were risk factors for the presence of EHFAs.