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Hepatocellular carcinoma: comparative study among precontrast, artery-dominant, and delayed-contrast phase images at
1Department of Radiology, Institute of Medical Science, University of Tokyo, Japan.
Insights
Detecting hepatocellular carcinoma (HCC) is improved using artery-dominant phase computed tomography (CT) scans. This phase offers superior HCC detection compared to precontrast and delayed phases, making it valuable for diagnosis.
Area of Science:
- Radiology
- Medical Imaging
- Oncology
Background:
- Hepatocellular carcinoma (HCC) is a primary liver malignancy.
- Accurate and early detection of HCC is crucial for effective treatment.
- Computed tomography (CT) is a key imaging modality for HCC evaluation.
Purpose of the Study:
- To assess the detectability of HCC during the artery-dominant phase of CT.
- To compare HCC detection rates across precontrast, artery-dominant, and delayed contrast phases.
- To determine the diagnostic utility of incremental dynamic CT for HCC.
Main Methods:
- 34 patients with 109 HCCs underwent ultrafast CT with an incremental dynamic technique.
- Images were acquired in precontrast, artery-dominant, and delayed contrast phases.
- Results were compared against iodized-oil CT images for validation.
Main Results:
- HCC detectability was significantly higher in the artery-dominant phase (80%) compared to precontrast (29%) and delayed (52%) phases (p < .01).
- No HCCs were detected solely in the precontrast phase.
- The artery-dominant phase identified all lesions missed in the delayed phase, demonstrating its superior sensitivity.
Conclusions:
- Incremental dynamic CT at the artery-dominant phase is highly suitable for HCC diagnosis.
- Precontrast CT phases are generally unnecessary for HCC detection.
- Delayed-phase images can provide supplementary information on tumor extent.
Abstract:
To evaluate the detectability of hepatocellular carcinoma (HCC) at artery-dominant phase and to compare it with that at precontrast and delayed-contrast phases, 34 patients with 109 HCCs were examined by ultrafast computed tomography (CT) using an incremental dynamic technique under single breath-holding. Images of three phases (precontrast, artery-dominant, and delayed) were compared with iodized-oil CT images. None of the lesions were detected only at precontrast phase. HCC detectability at the artery-dominant phase (87/109, 80%) was significantly superior to that at precontrast phase (32/109, 29%) (p < .01) and delayed-contrast phase (57/109, 52%) (p < .01). All 31 lesions missed at delayed-contrast phase were depicted at artery-dominant phase, while one lesion observed at delayed-contrast phase was missed at artery-dominant phase. Incremental dynamic CT at artery-dominant phase was suitable for the diagnosis of HCCs. Precontrast phase images were not necessary, although delayed-phase images were useful for the evaluation of tumor extension in some cases.