Abstract: Objective To investigate the relationship between perfusion parameters and therapeutic effect of 320-row volume CT scan after transcatheter artery chemoembolization (TACE) for liver cancer. Methods A total of 120 patients with liver cancer admitted to our hospital from January 2019 to June 2022 were selected and studied, all of whom received TACE surgery. They were divided into the effective group (n=88) and the ineffective group (n=32) according to the postoperative efficacy criteria for solid tumors. Statistical data was compared between the two groups using χ² test. And we used t test to compare the measurement data between the two groups. The gender, age, liver envelope penetration, degree of tumor differentiation, plasma alpha-fetoprotein (AFP) concentration, portal vein cancer embolus, intraoperative blood loss, hepatic artery perfusion (HAP), hepatic blood flow (HBF), hepatic perfusion index (HPI) were compared between the two groups. Multivariate Logistic regression analysis was used to analyze the risk factors of ineffective TACE treatment for liver cancer. Receiver operating characteristic (ROC) curve was drawn to evaluate the efficacy of HAP, HBF and HPI in predicting the failure of TACE treatment for liver cancer. Pearson correlation was used to analyze the relationship between CT perfusion parameters and TACE treatment for liver cancer. Results In the effective group and ineffective group, the comparison of Liver envelope penetration was 45.45% vs. 68.75% (χ²=5.100, P=0.024) and portal vein cancer thrombus was 43.18% vs. 65.63% (χ²=4.729, P=0.030). The proportion of patients in the ineffective group was significantly higher than that in the effective group (P<0.05). HAP (8.89±1.78 vs. 13.04±2.86, t=9.493, P=0.000), HBF (101.24±16.83 vs. 118.08±19.66, t=4.630, P=0.000) and HPI (28.15±4.69 vs. 37.48±6.47), t=8.664, P=0.000) was significantly lower than that in effective group, and the difference was statistically significant (P<0.05). Multivariate logistic regression analysis confirmed that liver envelope penetration, portal vein cancer thrombus, HAP, HBF and HPI were all risk factors affecting the efficacy of TACE treatment for liver cancer, and the OR values were 2.396 (95%CI: 1.017~5.644), 2.308 (95%CI: 1.030~5.632), 1.542 (95%CI: 1.127~2.057), 1.696 (95%CI: 1.026~1.804) and 2.011 (95%CI: 1.211~2.339) respectively. The P value were all lower than 0.05. ROC analysis proved that CT perfusion parameters HAP, HBF and HPI could be used to predict the therapeutic effect of TACE for liver cancer. The area under the curve was 0.907, 0.740 and 0.908, respectively, and the optimal cut-off value was 10.825, 112.437 and 31.542, respectively, with P<0.05. Correlation analysis showed that CT perfusion parameters HAP, HBF and HPI were negatively correlated with TACE treatment effect (r=-0.553, -0.312, -0.448, P<0.05). Conclusion Perfusion parameters of CT scan were negatively correlated with the therapeutic effect of TACE for liver cancer, and liver envelope penetration, portal vein cancer thrombus, HAP > 10.825, HBF > 112.437, HPI > 31.542 were all risk factors affecting the therapeutic effect of TACE for liver cancer. These indicators can be used as the markers to evaluate the therapeutic effect of TACE, providing reference for clinical assessment and treatment.

Key words: Liver cancer, Hepatic arterial chemoembolization, Perfusion parameters of 320-row volume CT scan, Therapeutic effect