CASE REPORT article
Front. Oncol.
Sec. Cancer Imaging and Image-directed Interventions
Cone-Beam CT–Derived Parenchymal Blood Volume Imaging for Guiding Transarterial Chemoembolization of Hypovascular Liver Metastases: A Case Report
Provisionally accepted
Hao Wang*
Xiaotong Liu
Ying LiuEncheng LiuBing LvYilong Jiao
Guang ChenBin GaoHaijun GaoHaonan zhangGuang Chen*- Tianjin First Central Hospital, Tianjin, China
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This case report describes the innovative integration of Cone-beam CT (CBCT) – derived parenchymal blood volume (PBV) mapping with embolization guidance technology to successfully direct the combined treatment of transarterial chemoembolization (TACE) and cryoablation of in a 70-year-old female with recurrent, hypovascular gallbladder liver metastases. By utilizing PBV software to quantitatively analyze tumor perfusion patterns through cone-beam CT acquisitions, the interventional team overcame the diagnostic limitations of conventional angiography in visualizing these typically occult lesions, identifying a characteristic peripheral hyperperfusion signature. Subsequently, the embolization guidance software automatically detected the tumor-feeding arteries and projected this information onto real-time fluoroscopy, enabling precise superselective catheterization. Post-TACE lipiodol deposition served as a radiopaque marker for accurate cryoablation probe placement under CT guidance. The procedural endpoint was objectively confirmed by a quantifiable change in PBV values, transitioning from pre-operative hypoperfusion to a post-operative "black cavity" pattern, indicative of complete treatment response. This novel multi-modal image-guided approach establishes a new paradigm for managing complex hepatic metastases, providing a comprehensive single-session solution for lesion identification, targeted embolization, and verified ablation.
Keywords: Cryoablation, Embolization Guidance Technology, Hypovascular Liver Metastases, PBV Imaging, TACE
Received: 30 Dec 2025; Accepted: 03 Feb 2026.
Copyright: © 2026 Wang, Liu, Liu, Liu, Lv, Jiao, Chen, Gao, Gao, zhang and Chen. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Hao Wang
Guang Chen
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