Diagnostic accuracy of helical CT arterial portography and CT hepatic arteriography for hypervascular hepatocellular carcinoma in chronic liver damage. An ROC analysis.
OBJECTIVE
To evaluate the detectability of hypervascular hepatocellular carcinomas (HCCs) in chronic liver damage with helical CT arterial portography (CTAP) and CT hepatic arteriography (CTHA).


METHODS
Thirty-nine HCC patients who underwent CTAP and CTHA were studied. Diagnostic abilities of CTAP alone, CTHA alone, or combined CTAP and CTHA were evaluated by receiver operating characteristic (ROC) analysis. Fifty-three images with 53 HCC nodules were evaluated. Tumor size ranged from 5 to 90 mm (mean 22.8 mm). Sensitivities and specificities for all techniques were calculated.


RESULTS
ROC analysis showed the diagnostic ability significantly better with combined CTAP and CTHA (mean area under the ROC curve (Az)=0.95), or CTHA alone (Az=0.93) than CTAP alone (Az=0.87) (p<0.01). Combined CTAP and CTHA showed the best sensitivity (95.0%), followed by CTHA alone (88.1%) and CTAP alone (85.5%). The specificities of all three imaging techniques were relatively low (54.1% for combined CTAP and CTHA, 71.1% for CTHA alone, and 54.1% for CTAP alone) because of perfusion abnormalities of the liver parenchyma.


CONCLUSIONS
The combination of CTAP and CTHA is superior to CTAP alone for detection of hypervascular HCCs. However, its specificity was relatively low in chronic liver damage.
Makita
O
O
Department of Radiology, Kumamoto University School of Medicine, Japan.
Yamashita
Y
Y
Arakawa
A
A
Nakayama
Y
Y
Mitsuzaki
K
K
Ando
M
M
Namimoto
T
T
Takahashi
M
M
D000368:Aged; D000369:Aged, 80 and over; D015901:Angiography, Digital Subtraction; D019540:Area Under Curve; D006528:Carcinoma, Hepatocellular / Q000150:complications / Q000000981:diagnostic imaging*; D016009:Chi-Square Distribution; D002908:Chronic Disease; D003287:Contrast Media; D005260:Female; D006499:Hepatic Artery / Q000000981:diagnostic imaging*; D019694:Hepatitis B, Chronic / Q000150:complications / Q000000981:diagnostic imaging; D019698:Hepatitis C, Chronic / Q000150:complications / Q000000981:diagnostic imaging; D006521:Hepatitis, Chronic / Q000150:complications / Q000000981:diagnostic imaging*; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods; D008104:Liver Cirrhosis, Alcoholic / Q000150:complications / Q000000981:diagnostic imaging*; D008113:Liver Neoplasms / Q000150:complications / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D011172:Portography / Q000379:methods*; D012372:ROC Curve; D015641:Radiography, Interventional; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods*
D003287:Contrast Media