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TACE Liver Tumour Embolization In Mumbai

Targeted Chemotherapy Delivered Directly to Liver Tumours Without Major Surgery

TACE (Transarterial Chemoembolization) is a minimally invasive interventional radiology procedure that delivers chemotherapy directly into the blood vessels supplying a liver tumour while simultaneously blocking the tumour's blood supply. At Shree Hospitals, our specialist interventional radiologists perform TACE for hepatocellular carcinoma (HCC), liver metastases, and other primary liver tumours, providing targeted tumour control with significantly fewer systemic side effects than conventional intravenous chemotherapy.

What is TACE (Transarterial Chemoembolization)?

TACE (Transarterial Chemoembolization) is an image-guided interventional radiology procedure that combines two tumour-fighting mechanisms in a single treatment. First, chemotherapy drugs (most commonly doxorubicin, cisplatin, or mitomycin-C) are delivered directly into the hepatic artery branches that supply the liver tumour - concentrating the drug at the tumour site at doses far higher than systemic intravenous chemotherapy could safely achieve. Second, embolic particles are injected to block the tumour's arterial blood supply, trapping the chemotherapy within the tumour while simultaneously causing tumour ischaemia (death from lack of oxygen).

The liver has a unique dual blood supply - receiving blood from both the hepatic artery (30%) and the portal vein (70%). Normal liver tissue derives most of its blood from the portal vein, while liver tumours are almost exclusively supplied by the hepatic artery. This anatomical difference is what makes TACE possible - by targeting the hepatic artery branches feeding the tumour, chemotherapy and embolization can be concentrated at the tumour with relative sparing of the normal liver. TACE is a key treatment for hepatocellular carcinoma (HCC) and is also used for neuroendocrine tumour (NET) liver metastases and other hypervascular liver metastases.

At Shree Hospitals, our interventional radiology team performs both conventional TACE (cTACE) using lipiodol-based chemotherapy emulsions and drug-eluting bead TACE (DEB-TACE) using microspheres that are pre-loaded with chemotherapy drug and release it slowly over time directly at the tumour. DEB-TACE offers more sustained local drug delivery and lower systemic drug levels compared to conventional TACE. All TACE procedures at Shree Hospitals are planned and reviewed in our multidisciplinary oncology team (MDT) meeting including oncologists, hepatologists, transplant surgeons, and interventional radiologists.

Who Is a Candidate for TACE?

TACE is indicated for patients with:

• Hepatocellular carcinoma (HCC) - the most common primary liver cancer - at intermediate stage (BCLC stage B) not suitable for curative resection or ablation
• Liver metastases from neuroendocrine tumours (NETs), colorectal cancer, or other hypervascular primary tumours
• HCC as bridge therapy - to control tumour progression while awaiting liver transplantation
• HCC as downstaging - to reduce tumour size or number to bring a patient within transplant criteria
• Patients with preserved liver function (Child-Pugh A or selected B) and no major portal vein thrombosis

Is TACE the Right Treatment for Your Liver Tumour?

TACE is appropriate when:

• Surgical resection or ablation (RFA/MWA) is not possible due to tumour size, number, or location
• Liver function (assessed by Child-Pugh score and bilirubin) is adequate to tolerate embolization
• Portal vein flow to the liver is intact (absence of main portal vein occlusion)
• The tumour has adequate arterial blood supply visible on pre-procedure imaging
• A multidisciplinary oncology team has reviewed the case and agreed TACE is the most appropriate treatment option

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Our Approach to TACE

At Shree Hospitals, TACE is never performed in isolation. Every patient is reviewed at our liver cancer multidisciplinary team (MDT) meeting before treatment is recommended. Our interventional radiologists, hepatologists, oncologists, and transplant surgeons jointly agree the treatment plan, the TACE technique, and the combination with systemic therapies where appropriate.

MDT Planning with Dedicated Liver Imaging

Every patient considered for TACE undergoes triple-phase contrast CT or MRI of the liver using hepatobiliary contrast agents to characterise each tumour, assess liver function, and plan the arterial supply to be targeted. Liver function tests, AFP tumour marker, Child-Pugh scoring, and ECOG performance status are assessed. The treatment plan is agreed at the liver cancer MDT meeting.

Selective and Super-Selective Embolization

During TACE, our interventional radiologists use advanced microcatheter techniques to achieve super-selective catheterisation of the arterial branches feeding each individual tumour segment, maximising drug delivery to the tumour while minimising embolization of the surrounding healthy liver. Cone-beam CT imaging is used intra-procedurally to confirm tumour targeting and completeness of treatment.

DEB-TACE for Sustained Drug Delivery

For appropriate patients, drug-eluting bead TACE (DEB-TACE) using calibrated LC Beads pre-loaded with doxorubicin provides more uniform drug elution over a sustained period directly at the tumour. DEB-TACE is associated with lower peak systemic doxorubicin levels compared to conventional TACE, reducing systemic side effects while maintaining or improving local drug concentrations within the tumour.

Interventional Radiology Services at Shree Hospitals

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