Tumor nontumorous liver tissues

Caturelli E et al. (2000) Transcatheter arterial chemoemboliza-tion for hepatocellular carcinoma in patients with cirrhosis evaluation of damage to nontumorous liver tissue-longterm prospective study. Radiology 215 123-128 Cauldwell EW et al. (1948) The bronchial arteries. An anatomic study of 150 human cadavers. Surg Gynecol Obstet 86 395 Charnsangavej C (1993) Chemoembolization of liver tumors. 

Results The mean CT values in the tumor were 332HU/pixel on day 0 and 291 on day 7 (see Figure 10.7). There was no significant difference. The mean CT values in the juxta-tumor nontumorous tissue decreased significantly from 166 to 60. The mean CT values in the nontumorous tissue 10 mm distant from the tumor decreased significantly from 142 to 62. The mean CT values in the control, noninjection part of the liver, were 65 on day 0 and 61 on day 7. 

The IPSO microdroplets injected into the hepatic artery inevitably flow into the peripheral branch of the artery, which runs through bile duct wall as a network called peribiliary plexus and finally connects to the portal vein or sinusoid (Kan, 1989) (see Figure 10.11). In the case of the liver bearing HCC, the tumor tissue is supplied with blood only by the hepatic artery, and not by the portal vein. Therefore immediately after the TACE with the W/OAV emulsion, the IPSO microdroplets accumulate in the hepatic artery along bile duct wall in nontumorous tissue and in tumor vessels in HCC tissue. 

Afterward, the microdroplets in nontumorous tissue flow via the sinusoid into the hepatic vein or Disse s space, which lies outside of sinusoidal space. The microdroplets entering Disse s space inevitably flow into the bile canalic-uli or lymphatic channels, finally out of the liver. In the HCC tissue the microdroplets remain there for a long time, probably because tumorous tissue is not equipped with a biliary or lymphatic drainage system. 

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