Hepatocellular carcinoma: detection with triple-phase multi-detector row helical CT in patients with chronic hepatitis.
OBJECTIVE
To evaluate whether the use of two arterial phase image acquisition series, when combined with portal venous phase imaging at multi-detector row helical computed tomography (CT), would be superior enough to use of a single arterial phase image acquisition series to warrant the increased radiation dose.


METHODS
Multi-detector row CT was performed in 77 patients with 140 foci of hepatocellular carcinoma (HCC). A triple-phase protocol that included an early arterial phase, a late arterial phase, and a portal venous phase was performed. Images were analyzed separately by three radiologists to document the presence and number of HCC nodules. Separate reading sessions were performed for images from the early arterial phase, images from the late arterial phase, images from both arterial phases combined, and images from all three phases. Sensitivity and positive predictive values were calculated for each reading session.


RESULTS
The average sensitivity and positive predictive values, respectively, for the detection of HCC were 48.5% and 96.4% for early arterial phase images, 87.1% and 94.0% for late arterial phase images, 87.1% and 94.0% for images from both arterial phases, and 88.5% and 93.4% for images from all three phases. Analysis of images from both arterial phases together yielded no improvement in either sensitivity or positive predictive value compared with analysis of late arterial phase images alone. Analysis of the combination of late arterial and portal venous phase images resulted in the highest sensitivity value.


CONCLUSIONS
The acquisition of images during two arterial contrast phases does not provide additional benefit over timed conventional biphasic CT technique.
Laghi
Andrea
A
Department of Radiology II, University of Rome-La Sapienza, Policlinico Umberto I, Viale Regina Elena 324, 00161 Rome, Italy. andrea.laghi@uniroma1.it
Iannaccone
Riccardo
R
Rossi
Plinio
P
Carbone
Iacopo
I
Ferrari
Riccardo
R
Mangiapane
Filippo
F
Nofroni
Italo
I
Passariello
Roberto
R
D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000150:complications / Q000000981:diagnostic imaging*; D003287:Contrast Media; D005260:Female; D019786:Gadolinium DTPA; D019694:Hepatitis B, Chronic / Q000150:complications*; D019698:Hepatitis C, Chronic / Q000150:complications*; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008113:Liver Neoplasms / Q000150:complications / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods*
D003287:Contrast Media; D019786:Gadolinium DTPA