Detection of hepatocellular carcinomas and dysplastic nodules in cirrhotic livers: accuracy of helical CT in transplant patients.
OBJECTIVE
The purpose of this study was to evaluate the diagnostic efficacy of three-phase helical dynamic CT in the detection and characterization of hepatocellular carcinomas and dysplastic nodules in cirrhotic livers.


METHODS
Three-phase helical dynamic CT in 41 patients with liver cirrhosis was evaluated prospectively before orthotopic liver transplantation. The numbers of hepatocellular carcinomas and dysplastic nodules were assessed in the explanted livers and compared with pretransplantation CT findings.


RESULTS
Examination of the explanted livers revealed 21 hepatocellular carcinomas in 15 patients and 23 dysplastic nodules in 10 patients. The size of the hepatocellular carcinomas was 0.6-5. 0 cm (mean, 1.9 cm), and that of the dysplastic nodules was 0.7-2.0 cm (mean, 1.0 cm). The use of helical dynamic CT enabled detection of 15 of 21 hepatocellular carcinomas (sensitivity, 71%) and nine of 23 dysplastic nodules (sensitivity, 39%). Patient sensitivity and specificity in the detection of hepatocellular carcinomas were 80% (12/15) and 96% (25/26), respectively, and for dysplastic nodules, 50% (5/10) and 97% (30/31), respectively.


CONCLUSIONS
Three-phase helical dynamic CT is relatively insensitive for detection of hepatocellular carcinomas and dysplastic nodules in cirrhotic livers, especially for dysplastic nodules and hepatocellular carcinomas smaller than 2 cm.
Lim
J H
JH
Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-dong, Kangnam-ku, 135-710 Seoul, Korea.
Kim
C K
CK
Lee
W J
WJ
Park
C K
CK
Koh
K C
KC
Paik
S W
SW
Joh
J W
JW
D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging* / Q000473:pathology* / Q000601:surgery; D006801:Humans; D008103:Liver Cirrhosis / Q000000981:diagnostic imaging* / Q000473:pathology* / Q000601:surgery; D008113:Liver Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology* / Q000601:surgery; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods