Detecting hepatic lesions: the added utility of CT liver window settings.
OBJECTIVE
To prospectively evaluate the utility of adding computed tomographic (CT) liver windows to conventional soft-tissue windows for the detection of hepatic disease.


METHODS
One of four radiologists experienced in abdominal imaging interpreted 1,175 consecutive abdominal CT scans from one institution. Hepatic images were first interpreted by using standard soft-tissue windows. The number of lesions and confidence in lesion detection were recorded. The liver-window images were then interpreted in conjunction with the soft-tissue-window images, and the number of lesions and confidence in detection were recorded again. The proportion of patients in whom additional lesions were found by using liver windows was determined.


RESULTS
On soft-tissue-window and liver-window scans interpreted together, 869 (74%) patients had no hepatic lesions. Thirty-six (3.1%) patients had new lesions seen with the addition of liver windows. Twelve of these 36 patients had no lesions seen on soft-tissue-window scans. Twenty-six of the 36 patients with additional lesions seen had a history of neoplasm. There was a change in diagnosis in 1.7% of the patients with the addition of liver windows and a change in recommendation for follow-up in 0.85%.


CONCLUSIONS
Routine interpretation of liver-window scans for all abdominal CT scans has limited added utility in detecting hepatic disease.
Mayo-Smith
W W
WW
Department of Diagnostic Imaging, Brown University School of Medicine, Rhode Island Hospital, Providence 02903, USA.
Gupta
H
H
Ridlen
M S
MS
Brody
J M
JM
Clements
N C
NC
Cronan
J J
JJ
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016009:Chi-Square Distribution; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods*; D008099:Liver / Q000000981:diagnostic imaging; D008107:Liver Diseases / Q000000981:diagnostic imaging*; D008113:Liver Neoplasms / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications; D015588:Observer Variation; D011446:Prospective Studies; D011860:Radiography, Abdominal; D014057:Tomography, X-Ray Computed / Q000379:methods*