Hypervascular hepatocellular carcinoma: detection with double arterial phase multi-detector row helical CT

Area of Science:

• Radiology
• Hepatobiliary Imaging
• Oncologic Imaging

Background:

• Hepatocellular carcinoma (HCC) is a common primary liver malignancy.
• Early and accurate detection of hypervascular HCC is crucial for effective patient management.
• Current imaging techniques may have limitations in fully characterizing hypervascular HCC lesions.

Purpose of the Study:

• To evaluate the efficacy of double arterial phase imaging using multi-detector row helical computed tomography (MDCT) for detecting hypervascular HCC.
• To compare the diagnostic performance of double arterial phase imaging against single arterial phase imaging (early and late) for HCC detection.

Main Methods:

• Fifty-one patients with known hypervascular HCC underwent dual arterial phase MDCT of the liver.
• Early and late arterial phase images were acquired sequentially with a 5.0-second interscan delay.
• Image analysis by three independent observers assessed sensitivity, positive predictive value, and AUC for HCC detection.

Main Results:

• Double arterial phase imaging achieved a sensitivity of 86% and a positive predictive value of 92% for hypervascular HCC.
• This dual-phase approach demonstrated significantly higher sensitivity (P < .05) and AUC compared to early or late phases alone.
• Double arterial phase imaging resulted in the fewest false-positive lesions.

Conclusions:

• Double arterial phase imaging is a recommended technique to enhance the detection of hypervascular HCC.
• This imaging strategy effectively improves diagnostic accuracy and reduces false-positive findings in HCC diagnosis.