Radiologic detectability of minute portal venous invasion in hepatocellular carcinoma.
OBJECTIVE
The objective of this study was to evaluate whether minute portal venous invasion in hepatocellular carcinoma (HCC) can be diagnosed radiologically.


METHODS
CT hepatic arteriography and CT with arterioportography (CTAP) of 15 patients with minute portal venous invasion (group 1) and 30 patients without it (group 0) were evaluated. An area showing low attenuation on CTAP and high attenuation on CT hepatic arteriography around the tumor was defined as an area of peritumoral hemodynamic change. The shape and size of the area were compared between the two groups. The ratio of the area of peritumoral hemodynamic change volume to tumor volume (area volume-tumor volume ratio) was used as an indicator of the size of the area of peritumoral hemodynamic change and was categorized as one of three grades: grade I, 10% or less; grade II, between 10% and 30%; and grade III, 30% or more. The detectability of minute portal invasion was assessed when grade III was considered as an indicator. Each comparison was also made independently when the tumor diameter either was limited to less than 3 cm or was 3 cm or more.


RESULTS
Three types of area of peritumoral hemodynamic change were identified: wedge-shaped, belt-shaped or irregular, and linear. No significant difference in the frequency of each type of area of peritumoral hemodynamic change was observed between the two groups. The area volume-tumor volume ratio in group 1 was larger than that in group 0, with statistical significance when the tumor diameter was less than 3 cm (p = 0.046). Positive and negative predictive values were 71.4% and 75.0%, respectively, when the tumor diameter was less than 3 cm.


CONCLUSIONS
The area of peritumoral hemodynamic change in HCC patients with minute portal invasion (group 1) may be larger than in those without it (group 0), especially when tumors are small.
Nishie
Akihiro
A
Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, 3-1-1, Maidashi, Higashi-ku, Fukuoka 812-8582, Japan. anishie@radiol.med.kyushu-u.ac.jp
Yoshimitsu
Kengo
K
Asayama
Yoshiki
Y
Irie
Hiroyuki
H
Tajima
Tsuyoshi
T
Hirakawa
Masakazu
M
Ishigami
Kousei
K
Nakayama
Tomohiro
T
Kakihara
Daisuke
D
Nishihara
Yunosuke
Y
Taketomi
Akinobu
A
Honda
Hiroshi
H
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000792:Angiography / Q000379:methods*; D006528:Carcinoma, Hepatocellular / Q000098:blood supply* / Q000000981:diagnostic imaging* / Q000473:pathology; D005260:Female; D006439:Hemodynamics; D006499:Hepatic Artery / Q000000981:diagnostic imaging*; D006801:Humans; D008113:Liver Neoplasms / Q000098:blood supply* / Q000000981:diagnostic imaging* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness / Q000000981:diagnostic imaging; D015588:Observer Variation; D011169:Portal Vein / Q000000981:diagnostic imaging*; D011172:Portography / Q000379:methods; D011379:Prognosis; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed