case_images: PMC10542216_01
case_images: Changes in case 1 in imaging and laboratory tests during clinical treatment. Enhanced CT images before introducing mHAIC. A 14x11 cm mass is shown in the right liver in the arterial phase (A), portal phase (B) and delayed phase (C). Enhanced CT images after introducing mHAIC. (D) DSA via an implantable port-catheter system, before mHAIC, demonstrated large tumour stains of HCC. (E) The subphrenic artery develops from the beginning of the renal artery and supplies blood to the tumour area. (F and G) After 4 cycles of mHAIC, DSA clipping of the hepatic and subphrenic arteries showed no tumour staining. A 7x6 cm mass is shown in the right liver in the arterial phase (H), portal phase (I) and delayed phase (J). (K) AFP level changes during postoperative mHAIC. (L) Changes in WBC, PLT, and HGB of patients during treatment. (M) Timeline of the treatment process.
case_images: JHC-10-1587-g0001.jpg
case_images: PMC10542216_01_JHC-10-1587-g0001.jpg
case_images: f0001
case_images: After admission, abdominal enhanced computed tomography (CT) showed a 14x11 cm liver tumour (Figure 1A-C). Digital subtraction angiography (DSA) via an implantable port-catheter system before mHAIC demonstrated multiple tumour stains of HCC (Figure 1D). The subphrenic artery from the renal artery supplied some of the blood to the tumour, as seen on DSA (Figure 1E). After 4 cycles of mHAIC, DSA clipping of the hepatic and subphrenic arteries showed no tumour staining (Figure 1F and G). The liver volume had grown, the shadow of the large mass in the right lobe of the liver had decreased, and the mass itself was mainly necrotic with no appreciable enhancement (Figure 1H-J). AFP level decreased to 15.8 ng/mL (Figure 1K) during the treatment period, and laboratory tests revealed haemoglobin (HGB), white blood cell (WBC), and platelet (PLT) changes with only grade 1 bone marrow suppression (Figure 1L). According to RECIST 1.1, the target lesion response was classified as a partial response (PR), whereas according to mRECIST, it was a complete response (CR).
case_images: PMC10542216_02
case_images: Changes in case 2 in imaging and laboratory tests during clinical treatment. Enhanced CT images before introducing mHAIC. A 6x5 cm mass is shown in the right liver in the arterial phase (A), portal phase (B) and delayed phase (C). (D) Hepatic angiography showing the thread and streaks sign, which implies a vascularized tumour thrombus. (E) After 4 cycles of mHAIC, DSA clipping of the hepatic arteries showed no tumour staining. Enhanced CT images after introducing mHAIC. A 2.0x1.5 cm mass is shown in the right liver in the arterial phase (F), portal phase (G) and delayed phase (H). (I) AFP level changes during postoperative mHAIC. (J) Changes in WBC, PLT and HGB of patients during treatment. (K) Timeline of the treatment process.
case_images: JHC-10-1587-g0002.jpg
case_images: PMC10542216_02_JHC-10-1587-g0002.jpg
case_images: f0002
case_images: The patient was diagnosed with HCC with PVTT, cirrhosis, and chronic viral hepatitis after an enhanced CT scan revealed a tumour measuring 8.9x7.8 cm (Figure 2A-C). The DSA right hepatic arteriogram showed an obscure staining of the right lobe of the liver, a triangular staining of the left lobe of the liver in the arterial phase, and a double track sign of the right hepatic artery and the main trunk of the left branch of the accompanying portal vein (Figure 2D). After 4 cycles of mHAIC, DSA clipping of the hepatic arteries showed no tumour staining (Figure 2E). An enhanced CT scan of the entire abdomen revealed that the abnormal improvement lesion in the lamellar blood vessel stage of the right lobe of the liver had shrunk significantly from its previous size, measuring approximately 2.0x1.5 cm with a blurred border (Figure 2F-H). AFP level decreased to 5.8 ng/mL (Figure 2I), and there were also changes in laboratory test results for HGB, WBC, and PLT, with a particularly marked decrease in platelets, but only grade 1 myelosuppression (Figure 2J). According to RECIST 1.1, the target lesion response was classified as PR, whereas according to mRECIST, it was classified as CR.