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Early hepatocellular carcinoma: appearance at CT during arterial portography and CT arteriography with pathologic
K Takayasu1, Y Muramatsu, H Furukawa
1Department of Radiology, National Cancer Center Hospital, Tokyo, Japan.
Insights
Computed tomography during arterial portography (CTAP) is not sensitive enough for early hepatocellular carcinoma (HCC) detection. CT arteriography shows promise for identifying early HCC, unlike CTAP which is standard for small HCC.
Area of Science:
- Radiology
- Hepatobiliary Imaging
- Oncology
Background:
- Hepatocellular carcinoma (HCC) is a primary liver malignancy.
- Early detection of HCC is crucial for effective treatment and improved patient outcomes.
- Differentiating early HCC from small HCC is essential for appropriate management strategies.
Purpose of the Study:
- To compare the hemodynamic properties of early hepatocellular carcinoma (HCC) with those of small HCC.
- To evaluate the efficacy of computed tomography during arterial portography (CTAP) and CT arteriography in detecting early and small HCC.
- To determine the optimal imaging modality for identifying early-stage HCC.
Main Methods:
- Retrospective analysis of 44 early HCCs and 90 small HCCs in 57 patients.
- Utilized computed tomography during arterial portography (CTAP) and CT arteriography.
- Compared imaging findings, including attenuation patterns, between early and small HCC cohorts.
Main Results:
- CTAP depicted early HCCs as hypoattenuating (23/35) or isoattenuating (12/35).
- CT arteriography showed early HCCs as hypoattenuating (11/20), isoattenuating (6/20), or hyperattenuating (3/20).
- CTAP identified 85/88 small HCCs as hypoattenuating, while CT arteriography identified 13/14 small HCCs as hyperattenuating.
Conclusions:
- Computed tomography during arterial portography (CTAP) is not sufficiently sensitive for detecting early hepatocellular carcinoma (HCC).
- CT arteriography demonstrates potential for improved detection of early HCC compared to CTAP.
- Further research into advanced imaging techniques is warranted for early HCC diagnosis.
Purpose:
To use computed tomography (CT) during arterial portography (CTAP) and CT arteriography to compare the hemodynamic properties of early hepatocellular carcinoma (HCC) with those of small HCC.
Materials And Methods:
Forty-four early HCCs (mean diameter, 1.5 cm) in 37 patients (26 men and 11 women aged 52-74 years; mean age, 59.2 years) were studied. CTAP was performed on 35 early HCCs, CT arteriography on 20, and both studies on 11. CTAP, CT arteriography, or both were performed on 90 small HCCs (mean diameter, 2.0 cm) in 57 patients (44 men and 13 women aged 48-71 years; mean age, 61 years). The findings for small HCC were compared with those for early HCC.
Results:
CTAP depicted 23 early HCCs as hypoattenuating masses and 12 as isoattenuating. CT arteriography depicted 11 early HCCs as hypoattenuating masses, six as isoattenuating, and three as hyperattenuating. CTAP depicted 85 of 88 small HCCs as hypoattenuating masses and three as isoattenuating. CT arteriography depicted 13 of 14 small HCCs as hyperattenuating masses.
Conclusion:
CTAP, the standard of reference for the detection of small HCC, is not sensitive enough for the detection of early HCC.