Hepatic metastasis detection: comparison of three CT contrast enhancement methods.
A prospective, blinded comparison of three methods of hepatic contrast enhancement in computed tomography (CT) was conducted in 15 patients with colorectal carcinoma metastatic to the liver. Arterial portography (AP-CT) was performed with injection of contrast material into the superior mesenteric artery during CT. Delayed scanning (DS-CT) was performed 4 hours after intravascular administration of contrast material (mean dose, 280 mL). CT with an ethiodized oil emulsion (EOE-CT) was performed 1 hour after slow intravenous infusion of the emulsion. All patients underwent laparotomy following imaging studies. A lesion-by-lesion analysis of 56 metastases showed no significant differences in sensitivity (AP-CT, 77%; DS-CT, 83%; EOE-CT, 82%), but the false-positive rate for AP-CT was significantly higher than that for DS-CT (P less than .001) or EOE-CT (P less than .01). False-positive rates for EOE-CT and DS-CT were not significantly different. The predictive value of a positive test was 63% for AP-CT, 90% for DS-CT, and 81% for EOE-CT. AP-CT does not appear to be clinically useful for detection of hepatic metastases because of the high false-positive rate. No difference could be demonstrated between DS-CT and EOE-CT. DS-CT is a valuable method for hepatic contrast enhancement.
Diagnostic Radiology Department, Clinical Center, Bethesda, MD 20892.
D L
DL
Miller
J T
JT
Simmons
R
R
Chang
B A
BA
Ward
T H
TH
Shawker
J L
JL
Doppman
A E
AE
Chang
D000328:Adult; D000368:Aged; D002277:Carcinoma / Q000000981:diagnostic imaging; D003110:Colonic Neoplasms / Q000000981:diagnostic imaging; D003287:Contrast Media; D005069:Evaluation Studies as Topic; D005189:False Positive Reactions; D005260:Female; D006499:Hepatic Artery / Q000000981:diagnostic imaging; D006801:Humans; D008099:Liver / Q000000981:diagnostic imaging; D008113:Liver Neoplasms / Q000000981:diagnostic imaging* / Q000556:secondary*; D008297:Male; D008875:Middle Aged; D011172:Portography; D011446:Prospective Studies; D011856:Radiographic Image Enhancement / Q000379:methods*; D012004:Rectal Neoplasms / Q000000981:diagnostic imaging; D014057:Tomography, X-Ray Computed / Q000379:methods*
D003287:Contrast Media