Abstract
Background
Most hepatocellular carcinomas (HCCs) are hypervascular and arise in the liver with chronicity. Spiral volumetric CT (SVCT) is a new rapid-scan technique that offers whole-liver scanning during the arterial-dominant phase. The main aim of the present study is to evaluate the detectability of hypervascular HCC with SVCT as compared with ultrasonography (US) and magnetic resonance (MR) imaging.
Methods
Forty-three hypervascular HCCs in 512 patients with chronic liver disease were examined with US, precontrast SVCT, postcontrast SVCT during the arterial-dominant phase (CT-ADP) and during the equivalent-phase (CT-EP) noncontrast MR imaging and angiography including SVCT during arteriography and arterial portography. Angiographic and follow-up findings were used as the gold standard if the lesion was not confirmed histologically.
Results
The sensitivity was 61% with precontrast CT, 84% with CT-ADP, 58% with CT-EP, 70% with US, 72% with MR, and 95% with the combination of these five modalities. Five HCCs (12%) were detected with only CT-ADP. The vascularity of HCC was correctly evaluated as hypervascular in 38 nodules (88%) with the combination of precontrast CT and CT-ADP.
Conclusions
We suggest that the combination of precontrast SVCT and CT-ADP is an essential modality to screen for HCC in patients with chronic liver disease. CT-EP did not contribute to the detection of hypervascular HCC.
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References
Kalender WA, Seissler W, Klotz E, Vock P. Spiral volumetric CT with single-breath-hold technique, continuous transport, and continuous scanner rotation.Radiology 1990;176:181–183
Costello P, Anderson W, Blume D. Pulmonary nodule: evaluation with spiral volmetric CT.Radiology 1991;179:875–876
Remy-Jardin M, Remy J, Giraud F, Marquette CH. Pulmonary nodules: detection with thick-section spiral CT versus conventional CT.Radiology 1993;187:513–520
Dupuy DE, Costello P, Ecker CP. Spiral CT of the pancreas.Radiology 1992;183:815–818
Urban BA, Fishman EK, Kuhlman JE, Kawashima A, Hennessey JG, Siegelman SS. Detection of focal hepatic lesions with spiral CT: comparison of 4- and 8-mm interscan spacing.AJR 1993;160:783–785
Bluemke D, Fishman EK. Spiral CT of the liver.AJR 1993;160:787–792
Shinagawa T, Ohto M, Kimura K, et al. Diagnosis and clinical features of small hepatocellular carcinoma with emphasis on the utility of real-time ultrasonography. A study in 51 patients.Gastroenterology 1984;86:495–502
Kobayashi K, Sugimoto T, Makino H, et al. Screening methods for early detection of hepatocellular carcinoma.Hepatology 1985;5:1100–1105
Nishioka K, Watanabe J, Furuta S, et al. A high prevalence of antibody to the hepatitis C virus in patients with hepatocellular carcinoma in Japan.Cancer 1991;67:429–433
Zaman SN, Melia WM, Johnson RD, Portmann BC, Johnson PJ, Williams R. Risk factors in development of hepatocellular carcinoma in cirrhosis: prospective study of 613 patients.Lancet 1985;i:1357–1360
Quinn SF, Benjamin GG. Hepatic cavernous hemangiomas: simple diagnostic sign with dynamic bolus CT.Radiology 1992;182:545–548
Nelson RC, Chezmar JL. Diagnostic approach to hepatic hemangiomas.Radiology 1990;176:11–13
Nakamura H, Hashimoto T, Oi H, Sawada S. Transcatheter oily chemoembolization of hepatocellular carcinoma.Radiology 1989;170:783–786
Shiina S, Tagawa K, Unuma T, et al. Percutaneous ethanol injection therapy of hepatocellular carcinoma: analysis of 77 patients.AJR 1990;155:1221–1226
Tanaka K, Nakamura S, Numata K, et al. Hepatocellular carcinoma: treatment with percutaneous ethanol injection and transcatheter arterial embolization.Radiology 1992;185:457–460
Matsui O, Kadoya M, Yoshikawa J, et al. Small hepatocellular carcinoma: treatment with subsegmental transcatheter arterial embolization.Radiology 1993;188:79–83
Heiken JP, Weyman PJ, Lee JKT, et al. Detection of focal hepatic masses: prospective evaluation with CT, delayed CT, CT during arterial portography, and MR imaging.Radiology 1989;171:47–51
Nelson RC, Chezmar JL, Sugarbaker PH, Bernardino ME. Hepatic tumors: comparison of CT during arterial portography, delayed CT, and MR imaging for preoperative evaluation.Radiology 1989;172:27–34
Santis MD, Romagnoli R, Cristani A, et al. MRI of hepatocellular carcinoma: comparison with US, CT, DSA, and lipiodol CT.J Comput Assist Tomogr 1992;16:189–197
Choi BI, Park JH, Kim BH, et al. Small hepatocellular carcinoma: detection with sonography, computed tomography (CT), angiography and lipiodol-CT.Br J Radiol 1989;62:897–903
Takayasu K, Moriyama N, Muramatsu Y. The diagnosis of small hepatocellular carcinomas: efficacy of various imaging procedures in 100 patients.AJR 1990;155:49–54
Ohishi H, Uchida H, Yoshimura H, et al. Hepatocellular carcinoma detected by iodized oil: use of anticancerous agents.Radiology 1985;154:25–29
Merine D, Takayasu K, Wakao F. Detection of hepatocellular carcinoma: comparison of CT during arterial portography with CT after intraarterial injection of iodized oil.Radiology 1990;175:707–710
Matsui O, Takashima T, Kadoya M, et al. Dynamic computed tomography during arteial portography: the most sensitive examination for small hepatocellular carcinomas.J Comput Assist Tomogr 1985;9:19–24
Marchal GJ, Baert AL, Wilms GE. CT of noncystic liver lesions: bolus enhancement.AJR 1980;135:57–65
Walkey MM. Dynamic hepatic CT: how many years will it take'til we learn?Radiology 1991;181:17–18
Cox IH, Foley WD, Hoffmann RG. Right window for dynamic hepatic CT.Radiology 1991;181:18–21
Walkey MM. Dr. Walkey replies.Radiology 1991;181:21–22
Foley WD, Berland LL, Lawson TL, et al. Contrast enhancement technique for dynamic hepatic computed tomographic scanning.Radiology 1983;147:797–803
Zeman RK, Fox SH, Silverman PM, et al. Helical (spiral) CT of the abdomen.AJR 1993;160:719–725
Yoshimatsu S, Inoue Y, Ibukuro K, Suzuki S. Hypovascular hepatocellular carcinoma undetected at angiography and CT with iodized oil.Radiology 1989;171:343–347
Matsui O, Kadoya M, Kameyama T, et al. Benign and malignant nodules in cirrhotic livers: distinction based on blood supply.Radiology 1991;178:493–497
Ueda K, Terada T, Nakanuma Y, Matsui O. Vascular supply in adenomatous hyperplasia of the liver and hepatocellular carcinoma: a morphometric study.Hum Pathol 1992;23:619–626
Tochio H, Tomita S, Kudo M, et al. Growth speed of hepatocellular carcinoma. Relationship with arterial vascularity evaluated by US angiography [English abstract].Acta Hepatol Jpn 1992;33:758–765
Bruce AU, Fishman EK, Kuhlman JE, et al. Detection of focal lesions with spiral CT: comparison of 4- and 8-mm interscan spacing.AJR 1993;160:783–785
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Ueda, K., Kitagawa, K., Kadoya, M. et al. Detection of hypervascular hepatocellular carcinoma by using spiral volumetric CT: Comparison of US and MR imaging. Abdom Imaging 20, 547–553 (1995). https://doi.org/10.1007/BF01256709
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DOI: https://doi.org/10.1007/BF01256709