Practical Tips for Transarterial Chemoembolization

Thierry de Baère, MD, Gustave Roussy Cancer Institute, Paris, France, shares his top 5 clinical tips to keep in mind when administering conventional transarterial chemoembolization (TACE). Dr de Baère highlights patient selection, cone beam computer tomography (CBCT), and water-in-oil emulsions.

Transcript:

Hello, I'm Thierry de Baère. I'm working at the Gustave Roussy Cancer Institute.

The first tip is to stick to the guideline for patient selection. You have to select patients where you deliver selective treatments using a small size microcatheter. The second one is CBCT is mandatory for tumor depictions for navigation, and we must use very sophisticated software to navigate to the tumor.

Third, you have to inject water-in-oil emulsions, which mean drugs within lipiodol. And to prepare this emulsion, there are 2 tricks. It’s a small volume of drugs that you have to push toward lipiodol. Ideally, you do it incrementally, so you have to split your drugs in 2 or 3 aliquots that you can add one after the other.

The fourth, this is TACE, so there is embolization, and you have to embolize after drug lipiodol delivery. And the fifth one is CBCT again, because you have to check for the delivery of your treatment, and you have to check that you covered the whole volume of tumor.