Current Trends in the Treatment of Hepatocellular Carcinoma with Transarterial Embolization: Variability in Technical Aspects

Paul Craig, Shamar J Young, Jafar Golzarian

Research output: Contribution to journalArticlepeer-review

19 Scopus citations


PURPOSE: While transarterial chemoembolization (TACE) is a mainstay of treatment for unresectable hepatocellular carcinomas (HCCs), technical aspects have varied considerably in the literature. These variations lead to heterogeneity and make meaningful comparisons between articles difficult. The goal of this survey was to report international embolization practices for the treatment of HCC in an effort to understand current treatment strategies as a first step toward technique standardization.

MATERIALS AND METHODS: An anonymous 18 question online survey, evaluating technical aspects of TACE, was distributed via e-mail to practicing members of the five largest interventional radiology societies in Chinese and English. A total of 1160 responses were obtained from 62 countries.

RESULTS: Between regions, there were significant statistical differences in nearly all responses, including the amount of ethiodol oil used for cTACE (p = < 0.001). Practitioners most commonly used greater than 7.5 ml of ethiodol oil (240/506, 47.4%) and most did not utilize a specific mixing method (249/505, 49.3%). Particles utilized varied by geographical region (p = < 0.001), spherical embolic particles were slightly favored (363/757, 47.9%), followed closely by gelatin-based or sponge particles (279/680, 36.8%). Gelfoam was used almost exclusively in Japan and Korea (79/82 responses). LC/DC beads were the most commonly used drug-eluting bead (DEB) (450/742, 60.6%), with the most common size of DEB being 100-300 μm (354/690, 51.3%, p = 0.07).

CONCLUSION: Technical aspects of transarterial embolization for HCC vary significantly by geographical location.

Original languageEnglish (US)
Pages (from-to)1322-1328
Number of pages7
JournalCardiovascular and Interventional Radiology
Issue number9
StatePublished - Sep 15 2019

Bibliographical note

Publisher Copyright:
© 2019, Springer Science+Business Media, LLC, part of Springer Nature and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE).


  • Chemoembolization
  • Hepatocellular carcinoma (HCC)
  • Survey
  • Gelatin Sponge, Absorbable/administration & dosage
  • Antineoplastic Agents/administration & dosage
  • Humans
  • Radiology, Interventional/methods
  • Treatment Outcome
  • Hemostatics/administration & dosage
  • Carcinoma, Hepatocellular/therapy
  • Ethiodized Oil/administration & dosage
  • Health Care Surveys/methods
  • Liver Neoplasms/therapy
  • Internationality
  • Chemoembolization, Therapeutic/methods

PubMed: MeSH publication types

  • Journal Article


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