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Iodine quantification to distinguish hepatic neuroendocrine tumor metastasis from hepatocellular carcinoma at dual-source dual-energy liver CT.

Abstract：

PURPOSE:To investigate the value of third-generation dual-source dual-energy computed tomography (DECT) iodine quantification to distinguish hepatic neuroendocrine tumor (NET) metastasis from hepatocellular carcinoma (HCC) in non-cirrhotic liver parenchyma. MATERIAL AND METHODS:Forty-six patients (mean age, 64.9 ± 10.1 years; 28 male and 18 female) with either hepatic NET metastasis or HCC, who had undergone liver DECT, were included in this retrospective study. For each lesion, arterial-phase attenuation values and DECT quantitative parameters, including iodine uptake, fat fraction, normalized iodine uptake (NIU), and lesion-to-liver-parenchyma ratio (LPR) were evaluated. Available cumulative data from histopathology, MRI, PET/CT, or interval imaging follow-up served as the reference standard for all liver lesions. In addition, the diagnostic accuracy of contrast-enhanced and material decomposition analysis for the differentiation of hepatic NET metastasis and HCC was assessed using receiver operating characteristics (ROC) curve analysis. RESULTS:Hepatic NET metastasis and HCC showed significant differences in arterial attenuation (P = 0.003), iodine uptake (P < 0.001), NIU (P < 0.001), and LPR (P = 0.003). No significant differences were found for unenhanced attenuation and fat fraction values (P = 0.686 and P = 0.892, respectively). NIU showed superior sensitivity (100%; iodine uptake, 71%), while both iodine uptake and NIU revealed superior specificity (100% and 90%, respectively) compared to LPR (sensitivity, 96%; specificity, 80%) and arterial attenuation analysis (sensitivity, 79%; specificity, 80%) (P ≤ 0.016). CONCLUSION:Third-generation DECT with assessment of iodine uptake improves the differentiation of hepatic NET metastasis and HCC in non-cirrhotic liver, with NIU showing the strongest diagnostic performance.

journal_name

Eur J Radiol

journal_title

European journal of radiology

authors

Kaltenbach B,Wichmann JL,Pfeifer S,Albrecht MH,Booz C,Lenga L,Hammerstingl R,D'Angelo T,Vogl TJ,Martin SS

doi

10.1016/j.ejrad.2018.05.019

subject

Has Abstract

pub_date

2018-08-01 00:00:00

pages

20-24

eissn

0720-048X

issn

1872-7727

pii

S0720-048X(18)30180-3

journal_volume

105

pub_type

杂志文章

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Iodine quantification to distinguish hepatic neuroendocrine tumor metastasis from hepatocellular carcinoma at dual-source dual-energy liver CT.