Helical CT during arterial portography and hepatic arteriography for detecting hypervascular hepatocellular carcinoma.
OBJECTIVE
We assessed whether helical CT hepatic arteriography (CTHA) improves detection of hypervascular hepatocellular carcinoma (HCC) when used in conjunction with helical CT obtained during arterial portography (CTAP).


METHODS
One hundred two patients with 254 hypervascular HCC nodules underwent both CTHA and CTAP. CTHA and CTAP were separately interpreted for detection of hypervascular HCC nodules by three observers who were unaware of tumor burden in the liver, lodized oil CT performed 1 week and 1 month after transcatheter arterial chemoembolization with iodized oil was the gold standard. Sensitivity and positive predictive value for CTHA alone, CTAP alone, and CTAP and CTHA combined were calculated and compared using the McNemar test.


RESULTS
We found no significant difference between the sensitivity of CTAP (85%) and CTHA (87%) for revealing hypervascular HCC nodules. The combination of CTAP and CTHA showed significantly higher sensitivity than either CTAP or CTHA alone for revealing HCC nodules smaller than 20 mm in diameter (p < .01).


CONCLUSIONS
The combination of CTHA and CTAP is recommended to improve the detection sensitivity of small hypervascular HCC nodules.
Murakami
T
T
Department of Radiology, Osaka University Medical School, Japan.
Oi
H
H
Hori
M
M
Kim
T
T
Takahashi
S
S
Tomoda
K
K
Narumi
Y
Y
Nakamura
H
H
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000098:blood supply / Q000000981:diagnostic imaging*; D003287:Contrast Media / Q000008:administration & dosage; D005260:Female; D006499:Hepatic Artery / Q000000981:diagnostic imaging; D006801:Humans; D007269:Injections, Intra-Arterial; D008113:Liver Neoplasms / Q000098:blood supply / Q000000981:diagnostic imaging*; D008297:Male; D017538:Mesenteric Artery, Superior; D008875:Middle Aged; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D013157:Splenic Artery; D014057:Tomography, X-Ray Computed / Q000379:methods*
D003287:Contrast Media