title: Detection of liver metastases under 2 cm: comparison of different acquisition protocols in four row multidetector-CT (MDCT).
abstract: This study compared different acquisition protocols performance to detect small liver metastases (<2 cm). Thirty consecutive patients with histologically proven hepatic metastases were explored by MDCT at the liver equilibrium phase by four successive acquisitions. We compared the following protocols (1-4): 5/30/1.5 (section thickness/table speed/pitch); 5/15/0.75; 5/11.25/0.75; and 2.5/15/1.5 with the same X-ray dose. The gold standard was based on patient radiological follow-up. Evolutive lesions were considered as true positive (TP). The described lesions, not found on the follow-up exams despite tumoral progression, were considered as false positive (FP). Stable lesions could not be considered as metastasis and were eliminated. One hundred and seventy-six lesions were detected: 61 TP and 91 FP. Twenty-four lesions were eliminated. The mean kappa values for protocols 1, 2, 3 and 4 were, respectively, 0.43, 0.68, 0.73 and 0.51 (0.61-0.80: substantial agreement) and the mean areas under the ROC curve were, respectively, 0.76, 0.87, 0.86 and 0.80. The results of protocols 2 and 3 were significantly superior to those of protocols 1 and 4. MDCT protocols using thin sections or an increased table speed are less efficient in detecting small metastases.
authors.affiliation: Department of Diagnostic and Interventional Radiology, University Hospital Centre (CHUV), 1011 Lausanne, Switzerland. ninaabdelmoumene@hotmail.com
authors.forename: Amina
authors.initials: A
authors.lastname: Abdelmoumene
authors.forename: Patrick
authors.initials: P
authors.lastname: Chevallier
authors.forename: Marc
authors.initials: M
authors.lastname: Chalaron
authors.forename: Frédéric
authors.initials: F
authors.lastname: Schneider
authors.forename: Francis R
authors.initials: FR
authors.lastname: Verdun
authors.forename: Phillipe
authors.initials: P
authors.lastname: Frascarolo
authors.forename: Reto
authors.initials: R
authors.lastname: Meuli
authors.forename: Pierre
authors.initials: P
authors.lastname: Schnyder
authors.forename: Alban
authors.initials: A
authors.lastname: Denys
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000473:pathology; D002985:Clinical Protocols; D003110:Colonic Neoplasms / Q000473:pathology; D003287:Contrast Media; D018450:Disease Progression; D005189:False Positive Reactions; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods*; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000556:secondary*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011829:Radiation Dosage; D011857:Radiographic Image Interpretation, Computer-Assisted; D012004:Rectal Neoplasms / Q000473:pathology; D014057:Tomography, X-Ray Computed / Q000379:methods*; D014283:Triiodobenzoic Acids
chemical_list: D003287:Contrast Media; D014283:Triiodobenzoic Acids; C053571:iopentol