title: Multislice computed tomography using a triple-phase contrast protocol for preoperative assessment of hepatic tumor load in patients with hepatocellular carcinoma before liver transplantation.
abstract: For evaluation of triple-phase multislice computed tomography (CT) for assessment of hepatocellular carcinoma (HCC) before liver transplantation. All HCC patients who underwent liver transplantation at our institution between 2001 and 2006 and had contrast-enhanced abdominal 4-/16-slice CT [unenhanced, arterial (20 s delay), portal venous (40 s), and venous (80 s) scan] within 100 days before transplantation were enrolled retrospectively. CT data were reviewed by two observers. Results were correlated to histopathologic findings by means of a lesion-by-lesion evaluation. Thirty-two patients with 76 HCC-lesions were included. The lesion-based sensitivity of observer 1 and 2 was 78% (59/76) and 83% (63/76) (false positives, n = 6 and n = 10). The sensitivity of observer 1/2 was 89%/95% for lesions >20 mm (n = 37), 94% for lesions 11-20 mm (n = 18), and 43%/53% for lesions <10 mm (n = 21). The mean detection rates of unenhanced, arterial, portal venous, and venous phase scans were 30%, 74%, 59%, and 40%. All detected lesions were visible on arterial and/or portal venous scans (arterial only, 24%; portal venous only, 9%). Arterial and portal venous phase scans are the strongest contributors to the high detection rate of triple-phase multislice-CT in HCC. However, the detection of small HCC measuring <10 mm and false positive findings remains a challenge.
authors.affiliation: Klinik für Strahlenheilkunde, Campus Virchow-Klinikum, Diagnostische und Interventionelle Radiologie und Nuklearmedizin, Charité- Universitätsmedizin Berlin, Berlin, Germany. denecke@charite.de
authors.forename: Timm
authors.initials: T
authors.lastname: Denecke
authors.forename: Christian
authors.initials: C
authors.lastname: Grieser
authors.forename: Vera
authors.initials: V
authors.lastname: Fröling
authors.forename: Ingo G
authors.initials: IG
authors.lastname: Steffen
authors.forename: Birgit
authors.initials: B
authors.lastname: Rudolph
authors.forename: Lars
authors.initials: L
authors.lastname: Stelter
authors.forename: Lukas
authors.initials: L
authors.lastname: Lehmkuhl
authors.forename: Florian
authors.initials: F
authors.lastname: Streitparth
authors.forename: Jan
authors.initials: J
authors.lastname: Langrehr
authors.forename: Peter
authors.initials: P
authors.lastname: Neuhaus
authors.forename: Enrique
authors.initials: E
authors.lastname: Lopez Hänninen
mesh_terms: D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging*; D005188:False Negative Reactions; D005189:False Positive Reactions; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000000981:diagnostic imaging*; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D011300:Preoperative Care; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods*; D047368:Tumor Burden