[Three-phase dynamic helical CT for hepatocellular carcinoma: optimal scanning protocol]

Area of Science:

• Radiology
• Medical Imaging
• Hepatobiliary Imaging

Background:

• Hepatocellular carcinoma (HCC) detection relies on advanced imaging techniques.
• Optimizing contrast agent delivery and scanning protocols is crucial for accurate diagnosis.

Purpose of the Study:

• To determine the optimal scanning protocol for three-phase dynamic helical CT.
• To evaluate the efficacy of the optimized protocol in detecting hepatocellular carcinoma nodules.

Main Methods:

• Four scanning protocols involving varying contrast volumes and injection rates were tested in 20 patients.
• Time-density curves of the aorta and liver parenchyma were analyzed.
• The superior protocol was applied to 32 HCC patients for three-phase scanning (early, late, delayed).

Main Results:

• The biphasic contrast injection method (100 ml at 3.3 ml/sec, followed by 50 ml at 1.6 ml/sec) proved superior based on time-density curve analysis.
• Three-phase scanning using the optimized protocol detected 62 HCC nodules.
• Numerous nodules, especially those <10 mm, were identified, outperforming MRI detection rates.

Conclusions:

• The biphasic dynamic helical CT protocol is optimal for assessing hepatocellular carcinoma.
• This advanced CT technique offers superior sensitivity for detecting HCC nodules compared to MRI, aiding in earlier diagnosis and management.