Small hepatocellular carcinoma in patients undergoing liver transplantation: detection with CT after injection of iodized oil.
OBJECTIVE
To assess computed tomography (CT) with iodized oil for depiction of small hepatocellular carcinoma (HCC) before liver transplantation.


METHODS
Thirty-five consecutive cirrhotic patients underwent CT with iodized oil to determine the presence, number, size, and location of possible nodules. All patients underwent liver transplantation within 4 months after CT. Explanted livers were cut in 8-mm slices that corresponded to axial CT scan planes. Comparison between CT staging and pathologic findings was made.


RESULTS
Pathologic studies showed 17 HCC nodules (diameter, 0.9-4.0 cm) in nine of the 35 livers. CT depicted nine of these 17 nodules. Lesion-by-lesion analysis revealed a sensitivity of 53%; CT falsely depicted three additional nodules not confirmed with pathologic findings. Patient-by-patient analysis revealed an 89% sensitivity and an 88% specificity.


CONCLUSIONS
CT with iodized oil, when assessed lesion by lesion, has a low sensitivity. These results must be considered when liver resection is proposed for HCC.
D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D003287:Contrast Media / Q000008:administration & dosage; D006498:Hepatectomy; D006499:Hepatic Artery; D006801:Humans; D007269:Injections, Intra-Arterial; D007275:Injections, Intravenous; D007459:Iodized Oil / Q000008:administration & dosage; D008103:Liver Cirrhosis / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D008113:Liver Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D016031:Liver Transplantation; D009367:Neoplasm Staging; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods
D003287:Contrast Media; D007459:Iodized Oil