ABSTRACT
<p><b>OBJECTIVE</b>To investigate the value of quantitative iodine-based material decomposition images with gemstone spectral CT imaging in the follow-up of patients with hepatocellular carcinoma (HCC) after transcatheter arterial chemoebolization (TACE).</p><p><b>METHODS</b>Consecutive 32 HCC patients with previous TACE treatment were included in this study. For the follow-up, arterial phase (AP) and venous phase (VP) dual-phase CT scans were performed with a single-source dual-energy CT scanner (Discovery CT 750HD, GE Healthcare). Iodine concentrations were derived from iodine-based material-decomposition images in the liver parenchyma, tumors and coagulation necrosis (CN) areas. The iodine concentration difference (ICD) between the arterial-phase (AP) and venal-phase (VP) were quantitatively evaluated in different tissues.The lesion-to-normal parenchyma iodine concentration ratio (LNR) was calculated. ROC analysis was performed for the qualitative evaluation, and the area under ROC (Az) was calculated to represent the diagnostic ability of ICD and LNR.</p><p><b>RESULTS</b>In all the 32 HCC patients, the region of interesting (ROI) for iodine concentrations included liver parenchyma (n=42), tumors (n=28) and coagulation necrosis (n=24). During the AP the iodine concentration of CNs (median value 0.088 µg/mm(3)) appeared significantly higher than that of the tumors (0.064 µg/mm(3), P=0.022) and liver parenchyma (0.048 µg/mm(3), P=0.005). But it showed no significant difference between liver parenchyma and tumors (P=0.454). During the VP the iodine concentration in hepatic parenchyma (median value 0.181 µg/mm(3)) was significantly higher than that in CNs (0.140 µg/mm(3), P=0.042). There was no significant difference between liver parenchyma and tumors, CNs and tumors (both P>0.05). The median value of ICD in CNs was 0.006 µg/mm(3), significantly lower than that of the HCC (0.201 µg/mm(3), P<0.001) and hepatic parenchyma (0.117 µg/mm(3), P<0.001). The ICDs in tumors and hepatic parenchyma showed no significant difference (P=0.829). During the AP, the LNR had no significant difference between CNs and tumors (a median value 1.805 vs. 1.310, P=0.389), and during the VP, the difference was also non-significant (the median value 0.647 vs. 0.713, P=0.660). The mean Az value of ICDs for evaluation of surviving tumor tissues was 0.804, whiles LNR measured a disappointing result in both AV images and VP images.</p><p><b>CONCLUSION</b>Quantitative iodine-based material decomposition images with gemstone spectral CT imaging can improve the diagnostic efficacy of CT imaging for HCC patients after TACE treatment.</p>
Subject(s)
Humans , Arteries , Carcinoma, Hepatocellular , Diagnostic Imaging , Therapeutics , Embolization, Therapeutic , Follow-Up Studies , Iodides , Iodine , Liver Neoplasms , Diagnostic Imaging , Therapeutics , ROC Curve , Tomography, X-Ray ComputedABSTRACT
Objective To evaluate the detectability of dual-arterial phase of MRI and single-artery phase of CT scan for hepatocellular carcinoma (HCC). Methods A total of 39 patients with HCC underwent CT and MR scan, and 59 lesions of HCC were confirmed definitely. According to lesion size, the lesions were divided into 3 groups: >3 cm group (n=20), 1-3 cm group (n=27) and <1 cm group (n=12). CT was performed with 25 seconds delaying for artery phase. MR imaging was performed with liver accelerate volume acquisition (LAVA) technique, dual-artery phases included early artery phase of 17 seconds delaying and a mid-artery phase of 24 seconds delaying. The detectability of dual-artery phase of MR was compared with that of single-artery phase of CT. Results In <1 cm group, the sensitivity of CT single-artery phase images and MR dual-artery phase images in detecting HCC lesions was 50.00% (6/12) and 75.00% (9/12), respectively;the later showed a higher sensitivity (P=0.04). In groups of 1-3 cm and ＞3 cm, the sensitivity of the two technique had no statistical difference (66.67% vs 81.48% and 95.00% vs 95.00%). Conclusion For the detection of <1 cm HCC, dual-artery phase MRI has higher detectability than single artery phase enhancement CT.
ABSTRACT
Objective To compare the diagnostic ability of triple-phase CT and multiple-phase dynamic MR for patients with suspected hepatocellular carcinoma (HCC). Methods Triple-phase CT and multiple-phase dynamic MR scan were performed in 60 patients. Fifty-nine HCC lesions were confirmed in 39 patients. MR was performed with LAVA technique, the images included masks, dual-artery phases, dual-portal phases, dual-venous phases and delayed phase. Three observers separately evaluated the CT and MR imaging, and the results were compared with alternative-free-response ROC(AFROC)curve, the area under ROC (Az) was calculated to compare the diagnostic ability. Results The mean Az value of CT for the diagnosis of HCC was 0.8120±0.0118, of MR was 0.9093±0.0072 (P>0.05). In the group of HCC less than 1 cm in the diameter, the sensitivity of CT and MR was 63.89% and 80.55%(P＝0.013). In the groups HCCs of 1-3 cm and >3 cm, the sensitivity of CT and MR appeared no significant difference (P>0.05). Of all HCCs, the sensitivity of CT was lower than MR (83.62% vs 88.70%), but the difference was not significant (P>0.05). The positive predict value (PPV) of CT was also lower than MR (93.07% vs 96.31%, P>0.05). Conclusion The diagnostic ability of multiple-phase dynamic-enhancement MR scan for HCCs is similar to that of triple-phase enhancement CT. For HCC less than 1 cm in diameter, dynamic-enhancement MR is superior to that of contrast-enhancement CT scan, while for the larger ones, the difference is not significant.