US-CT 3D dual imaging by mutual display of the same sections for depicting minor changes in hepatocellular carcinoma

The purpose of this study was to evaluate the usefulness of ultrasound-computed tomography (US-CT) 3D dual imaging for the detection of small extranodular growths of hepatocellular carcinoma (HCC). The clinical and pathological profiles of 10 patients with single nodular type HCC with extranodular growth (extranodular growth) who underwent a hepatectomy were evaluated using two-dimensional (2D) ultrasonography (US), three-dimensional (3D) US, 3D computed tomography (CT) and 3D US-CT dual images. Raw 3D data was converted to DICOM (Digital Imaging and Communication in Medicine) data using Echo to CT (Toshiba Medical Systems Corp., Tokyo, Japan), and the 3D DICOM data was directly transferred to the image analysis system (ZioM900, ZIOSOFT Inc., Tokyo, Japan). By inputting the angle number (x, y, z) of the 3D CT volume data into the ZioM900, multiplanar reconstruction (MPR) images of the 3D CT data were displayed in a manner such that they resembled the conventional US images. Eleven extranodular growths were detected pathologically in 10 cases. 2D US was capable of depicting only 2 of the 11 extranodular growths. 3D CT was capable of depicting 4 of the 11 extranodular growths. On the other hand, 3D US was capable of depicting 10 of the 11 extranodular growths, and 3D US-CT dual images, which enable the dual analysis of the CT and US planes, revealed all 11 extranodular growths. In conclusion, US-CT 3D dual imaging may be useful for the detection of small extranodular growths.