Revealing hepatic metastases from colorectal cancer: value of combined helical CT during arterial portography and CT hepatic arteriography with a unified CT and angiography system.
OBJECTIVE
The purpose of our study was to evaluate the use of combined helical CT during arterial portography and CT hepatic arteriography in the preoperative assessment of hepatic metastases from colorectal cancer using a unified CT and angiography system.


METHODS
Fifty-four patients with hepatic metastases from colorectal cancer preoperatively underwent combined CT during arterial portography and CT hepatic arteriography using the unified CT and angiography system. Three radiologists independently and retrospectively reviewed the images of CT during arterial portography alone, CT hepatic arteriography alone, and combined CT during arterial portography and CT hepatic arteriography. Image review was conducted on a segment-by-segment basis; a total of 432 hepatic segments with (n = 103) 118 metastatic tumors ranging in size from 2 to 160 mm (mean, 25.8 mm) and without (n = 329) tumor were reviewed.


RESULTS
Relative sensitivity of combined CT during arterial portography and CT hepatic arteriography (87%) was higher than that of CT during arterial portography alone (80%, p < 0.0005) and CT hepatic arteriography alone (83%, p < 0.005). Relative specificity of CT hepatic arteriography alone (95%, p < 0.0005) and combined CT during arterial portography and CT hepatic arteriography (96%, p < 0.0001) was higher than that of CT during arterial portography alone (91%). Diagnostic accuracy, determined by a receiver operating characteristic curve analysis, was greater with combined CT during arterial portography and CT hepatic arteriography than with CT during arterial portography alone (p < 0.05) or CT hepatic arteriography alone (p < 0.01).


CONCLUSIONS
Using a unified CT and angiography system, we found that combined CT during arterial portography and CT hepatic arteriography significantly raised the detectability of hepatic metastases from colorectal cancer.
Inaba
Y
Y
Department of Diagnostic Radiology, Aichi Cancer Center, Nagoya, Japan.
Arai
Y
Y
Kanematsu
M
M
Takeuchi
Y
Y
Matsueda
K
K
Yasui
K
K
Hoshi
H
H
Itai
Y
Y
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000792:Angiography / Q000295:instrumentation / Q000379:methods*; D015179:Colorectal Neoplasms / Q000473:pathology*; D004867:Equipment Design; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000098:blood supply* / Q000000981:diagnostic imaging / Q000556:secondary*; D008297:Male; D008875:Middle Aged; D011172:Portography; D011300:Preoperative Care; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed