Dynamic Multi-Phase-Fused Photon-Counting CT for Pre-TACE Feeding Artery Mapping and DSA Procedural Road-Mapping in Hepatocellular Carcinoma.
- 1Department of Radiology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing 400010, China.
Abstract
Background/Objectives: Accurate preoperative feeding artery mapping remains challenging for hepatocellular carcinoma (HCC) even with modern CT techniques. This study aimed to optimize dynamic multi-phase photon-counting CT (PCCT) hepatic artery protocols and assess dynamic-fusion PCCT against best single-phase PCCT and energy-integrating-detector dual-energy CT (EID-DECT) for feeding artery detection, vascular-map construction and digital subtraction angiography (DSA) path-planning prior to transarterial chemoembolization (TACE) in HCC. Methods: This prospective single-center study contained workflow-optimization among cirrhotic non-HCC patients and clinical validation in TACE-candidate HCC patients. Two radiologists performed blinded independent reading. The composite reference standard consisted of DSA, selective/superselective angiography, available cone-beam computed tomography (CBCT) and embolization records. Primary endpoint: patient-level paired difference in DSA-verified feeding artery coverage. Secondary endpoints included complete-atlas rate, DSA-path-prediction accuracy, missed-vessel count and extrahepatic-supply detection. A pre-specified comparison between dynamic-fusion PCCT and EID-DECT was performed. Results: Dynamic phase 1-6 fusion was the optimal PCCT scheme, while optimal single-phase varied individually. Dynamic-fusion PCCT achieved superior feeding artery coverage (97.78% ± 8.61% vs. 88.33% ± 15.37%, difference 9.44 pp, 95% CI 1.82-17.06, p = 0.016), complete-atlas rate (93.3% vs. 53.3%, p = 0.039) and path-prediction accuracy (96.67% ± 11.18% vs. 80.00% ± 24.49%), with fewer missed culprit vessels. Two extrahepatic feeders were only detected by dynamic-fusion PCCT. Compared with EID-DECT, dynamic-fusion PCCT showed favorable atlas-related metrics without statistically significant difference in feeding artery coverage. Conclusions: Dynamic-fusion PCCT outperforms single-phase PCCT in pre-TACE feeding artery mapping and DSA path-prediction and shows potential benefits over EID-DECT. It delivers comprehensive preoperative vascular data and may reduce intraoperative exploratory procedures.
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BibTeX
@article{chen2026dynamic,
title = {{Dynamic Multi-Phase-Fused Photon-Counting CT for Pre-TACE Feeding Artery Mapping and DSA Procedural Road-Mapping in Hepatocellular Carcinoma.}},
author = {Hao Chen and Hao Deng and Xin Wei and Xi Liu and Weijuan Chen},
journal = {Cancers},
year = {2026},
month = sep,
doi = {10.3390/cancers18193152},
url = {https://europepmc.org/article/MED/42882847},
note = {CC BY},
}
RIS
TY - JOUR
TI - Dynamic Multi-Phase-Fused Photon-Counting CT for Pre-TACE Feeding Artery Mapping and DSA Procedural Road-Mapping in Hepatocellular Carcinoma.
AU - Hao Chen
AU - Hao Deng
AU - Xin Wei
AU - Xi Liu
AU - Weijuan Chen
PY - 2026
DA - 2026/09/29
JO - Cancers
DO - 10.3390/cancers18193152
UR - https://europepmc.org/article/MED/42882847
AB - Background/Objectives: Accurate preoperative feeding artery mapping remains challenging for hepatocellular carcinoma (HCC) even with modern CT techniques. This study aimed to optimize dynamic multi-phase photon-counting CT (PCCT) hepatic artery protocols and assess dynamic-fusion PCCT against best single-phase PCCT and energy-integrating-detector dual-energy CT (EID-DECT) for feeding artery detection, vascular-map construction and digital subtraction angiography (DSA) path-planning prior to transarterial chemoembolization (TACE) in HCC. Methods: This prospective single-center study contained workflow-optimization among cirrhotic non-HCC patients and clinical validation in TACE-candidate HCC patients. Two radiologists performed blinded independent reading. The composite reference standard consisted of DSA, selective/superselective angiography, available cone-beam computed tomography (CBCT) and embolization records. Primary endpoint: patient-level paired difference in DSA-verified feeding artery coverage. Secondary endpoints included complete-atlas rate, DSA-path-prediction accuracy, missed-vessel count and extrahepatic-supply detection. A pre-specified comparison between dynamic-fusion PCCT and EID-DECT was performed. Results: Dynamic phase 1-6 fusion was the optimal PCCT scheme, while optimal single-phase varied individually. Dynamic-fusion PCCT achieved superior feeding artery coverage (97.78% ± 8.61% vs. 88.33% ± 15.37%, difference 9.44 pp, 95% CI 1.82-17.06, p = 0.016), complete-atlas rate (93.3% vs. 53.3%, p = 0.039) and path-prediction accuracy (96.67% ± 11.18% vs. 80.00% ± 24.49%), with fewer missed culprit vessels. Two extrahepatic feeders were only detected by dynamic-fusion PCCT. Compared with EID-DECT, dynamic-fusion PCCT showed favorable atlas-related metrics without statistically significant difference in feeding artery coverage. Conclusions: Dynamic-fusion PCCT outperforms single-phase PCCT in pre-TACE feeding artery mapping and DSA path-prediction and shows potential benefits over EID-DECT. It delivers comprehensive preoperative vascular data and may reduce intraoperative exploratory procedures.
SN - 2072-6694
ER -