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Related Experiment Videos

Small hepatocellular carcinomas: two-phase dynamic incremental CT in detection and evaluation

I Ohashi1, K Hanafusa, T Yoshida

  • 1Department of Radiology, Tokyo Medical and Dental University, School of Medicine, Japan.

Radiology
|December 1, 1993
PubMed
Summary

Dynamic incremental computed tomography (CT) offers superior detection of small hepatocellular carcinomas (HCCs) compared to ultrasonography and iodized oil-enhanced CT. This two-phase CT technique is recommended for routine follow-up in chronic liver disease patients.

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Area of Science:

  • Hepatobiliary Imaging
  • Diagnostic Radiology
  • Oncology Imaging

Background:

  • Small hepatocellular carcinomas (HCCs) pose a diagnostic challenge.
  • Early detection is crucial for effective management of HCC.
  • Chronic liver disease patients require vigilant surveillance for HCC development.

Purpose of the Study:

  • To compare the efficacy of dynamic incremental computed tomography (CT) against other imaging modalities for detecting and evaluating small HCCs.
  • To determine the optimal imaging technique for routine follow-up of patients at risk for HCC.
  • To assess the sensitivity of dynamic incremental CT in identifying well-differentiated small HCCs.

Main Methods:

  • A two-phase dynamic incremental CT protocol (early vascular and parenchymal phases) was applied to 184 patients with chronic liver disease.

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  • Ultrasonography (US) was performed on all patients.
  • Thirty patients with confirmed small HCCs (diameter < 30 mm) underwent additional CT with intraarterial iodized oil injection for comparative analysis.

    • Main Results:

    • Dynamic incremental CT demonstrated a superior HCC detection rate of 92% compared to US (69%) and iodized oil-enhanced CT (81%).
    • For well-differentiated HCCs, the second dynamic incremental CT series achieved the highest detection rate (all six cases), followed by US (five cases).
    • Dynamic incremental CT proved effective in detecting small HCCs, including challenging well-differentiated lesions.

    Conclusions:

    • Two-phase dynamic incremental CT is a highly effective and user-friendly imaging method for the routine follow-up of patients with chronic liver disease.
    • This CT technique surpasses other methods in detecting and evaluating small hepatocellular carcinomas.
    • Dynamic incremental CT should be considered the preferred imaging modality for surveillance of at-risk populations.