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Detection of hepatocellular carcinoma: comparison of dynamic three-phase computed tomography images and four-phase computed tomography images using multidetector row helical computed tomography.

Abstract：

PURPOSE:The purpose of our study was to assess the value of additional early arterial phase computed tomography (CT) imaging in the detection of hepatocellular carcinoma (HCC) by comparing three-phase and four-phase imaging by using multidetector row helical CT. METHODS:Twenty-five patients with 33 HCCs underwent four-phase helical CT imaging. The diagnosis was established by pathologic examination after surgical resection in 19 patients and by biopsy in six. Four-phase CT imaging comprises early arterial, late arterial, portal venous, and delayed phase imaging obtained 25 seconds, 45 seconds, 75 seconds, and 180 seconds after the start of contrast material injection using multidetector row helical CT. Three-phase CT images (late arterial, portal venous, and delayed phase) and four-phase CT images (early arterial, late arterial, portal venous, and delayed phase) were interpreted independently for the detection of HCC by three blinded observers on a segment-by-segment basis. Sensitivity, specificity, and area under the receiver operating characteristic (ROC) curve (Az) for three-phase CT images and four-phase CT images were calculated. The enhancement pattern of HCC was analyzed on early arterial and late arterial phase imaging. RESULTS:The mean sensitivity of three- and four-phase CT images was 94% and 93%, respectively. The differences between sensitivities were not statistically significant (all p > 0.05). The mean specificities of three- and four-phase CT images were 99% and 98%, respectively. The differences between the specificities were not statistically significantly (all p > 0.05). Neither were the mean areas under the ROC curve for four-phase CT images (Az = 0.976) and three-phase CT images (Az = 0.971) statistically significant (p > 0.05). On early arterial phase imaging, 16 HCCs were hyperattenuating and 17 HCCs were isoattenuating. On late arterial phase imaging, 24 HCCs were hyperattenuating and nine HCCs were isoattenuating. CONCLUSIONS:Additional early arterial phase imaging did not improve the detection of HCC compared with three-phase CT images, including late arterial, portal venous, and delayed phase imaging.

journal_name

J Comput Assist Tomogr

journal_title

Journal of computer assisted tomography

authors

Kim SK,Lim JH,Lee WJ,Kim SH,Choi D,Lee SJ,Lim HK,Kim H

doi

10.1097/00004728-200209000-00005

keywords:

subject

Has Abstract

pub_date

2002-09-01 00:00:00

pages

691-8

issue

eissn

0363-8715

issn

1532-3145

pii

00004728-200209000-00005

journal_volume

pub_type

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Detection of hepatocellular carcinoma: comparison of dynamic three-phase computed tomography images and four-phase computed tomography images using multidetector row helical computed tomography.