title: A novel display of reconstruction computed tomography for the detection of small hepatocellular carcinoma.
abstract: OBJECTIVE
  To evaluate the usefulness of the alternate display of arterial and equilibrium phase images (ADAEI) of 2 mm-pitch reconstruction computed tomography (CT) in the detection of hepatocellular carcinoma (HCC).
  
  
  METHODS
  One hundred and eleven nodules in 72 patients were confirmed as HCC by radiology, histology, or clinical course. Blinded to the outcome, we retrospectively reviewed the CT images obtained with dual-phase spiral CT (Radix Prima, Hitachi Medical, Tokyo, Japan) by ADAEI and by conventional display on cut films. Scanning for the arterial and equilibrium phases was initiated at 33 and 120 s, respectively, after starting the injection of contrast medium (iopamidol 3 ml/s) with a section thickness of 5 mm and a table feed speed of 5-7 mm/s. In ADAEI, all images were reconstructed with a 2-mm interval, and displayed on the monitor in an alternating fashion so that an image in the arterial phase was followed by the corresponding image in the equilibrium phase, and then by the next pair of images in the craniocaudal direction.
  
  
  RESULTS
  All 20 HCC nodules larger than 20 mm in diameter were detected by both ADAEI and the conventional display (NS). On the other hand, detectability of smaller HCC nodules was 91/91 (100%) and 72/91 (79%), respectively (P<0.0001 by McNemar' test). False-positively identified HCC nodules, including those diagnosed as possible HCC, were 11 by ADAEI and eight by conventional display.
  
  
  CONCLUSIONS
  The novel, alternate display, ADAEI of 2 mm-pitch reconstruction CT images was useful in detecting small HCC nodules while not requiring additional equipment or expense.
authors.affiliation: University of Tokyo Graduate School of Medicine, Gastroenterology, Tokyo, Japan. teratani-2im@h.u-tokyo.ac.jp
authors.forename: Takuma
authors.initials: T
authors.lastname: Teratani
authors.forename: Haruhiko
authors.initials: H
authors.lastname: Yoshida
authors.forename: Yoshida
authors.initials: Y
authors.lastname: Haruhiko
authors.forename: Shuichiro
authors.initials: S
authors.lastname: Shiina
authors.forename: Shiina
authors.initials: S
authors.lastname: Shuichiro
authors.forename: Shuntaro
authors.initials: S
authors.lastname: Obi
authors.forename: Obi
authors.initials: O
authors.lastname: Shuntaro
authors.forename: Shinpei
authors.initials: S
authors.lastname: Sato
authors.forename: Sato
authors.initials: S
authors.lastname: Shinpei
authors.forename: Yukihiro
authors.initials: Y
authors.lastname: Koike
authors.forename: Koike
authors.initials: K
authors.lastname: Yukihiro
authors.forename: Keisuke
authors.initials: K
authors.lastname: Hamamura
authors.forename: Hamamura
authors.initials: H
authors.lastname: Keisuke
authors.forename: Masatoshi
authors.initials: M
authors.lastname: Akamatsu
authors.forename: Akamatsu
authors.initials: A
authors.lastname: Masatoshi
authors.forename: Tomonori
authors.initials: T
authors.lastname: Fujishima
authors.forename: Fujishima
authors.initials: F
authors.lastname: Tomonori
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Imai
authors.forename: Imai
authors.initials: I
authors.lastname: Yasuo
authors.forename: Takao
authors.initials: T
authors.lastname: Kawabe
authors.forename: Kawabe
authors.initials: K
authors.lastname: Takao
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Shiratori
authors.forename: Shiratori
authors.initials: S
authors.lastname: Yasushi
authors.forename: Masao
authors.initials: M
authors.lastname: Omata
authors.forename: Omata
authors.initials: O
authors.lastname: Masao
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D015331:Cohort Studies; D003287:Contrast Media; D005189:False Positive Reactions; D005260:Female; D005500:Follow-Up Studies; D006498:Hepatectomy / Q000379:methods; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008113:Liver Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011336:Probability; D011446:Prospective Studies; D011856:Radiographic Image Enhancement; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D036542:Tomography, Spiral Computed; D016896:Treatment Outcome
chemical_list: D003287:Contrast Media