Triple-phase computed tomography during arterial portography with bolus tracking for hepatic tumors.
OBJECTIVE
The purpose of this study was to assess the usefulness of triple-phase computed tomography during arterial portography (CTAP) using a bolus-tracking technique.


METHODS
The subjects were 60 patients with hepatic tumors: 20 patients with metastatic liver tumors with a normal liver and 40 with hypervascular hepatocellular carcinoma (HCC) with liver cirrhosis. The region of interest was set in the portal vein, and CTAP was automatically started after the triggering threshold (180 HU) was reached. Three scans were performed: early phase (E), hepatic parenchymal phase (HP), and late phase (L). The scan start time of E-CTAP was measured. The detection rates of the HCC nodules were evaluated during each CTAP phase.


RESULTS
CTAP was performed by bolus tracking without failure in any of the patients. The mean scan start times in the normal liver group and liver cirrhosis group were 14.3 +/- 1.34 s and 18.5 +/- 2.46 s, respectively, which were significantly different from each other. The detection rates of HCC nodules for E-CTAP, HP-CTAP, and L-CTAP were 29.6%, 100%, and 83.3%, respectively.


CONCLUSIONS
The bolus-tracking technique enabled us to perform CTAP with optimal timing regardless of the portal blood flow dynamics.
Nakai
Motoki
M
Department of Radiology, Wakayama Medical University, Wakayama, Japan. momonga@wakayama-med.ac.jp
Sato
Morio
M
Ikoma
Akira
A
Nakata
Kohei
K
Sahara
Shinya
S
Takasaka
Isao
I
Minamiguchi
Hiroki
H
Kawai
Nobuyuki
N
Sonomura
Tetsuro
T
Kishi
Kazushi
K
D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000150:complications / Q000000981:diagnostic imaging* / Q000473:pathology; D003287:Contrast Media; D004067:Digestive System Neoplasms / Q000150:complications / Q000000981:diagnostic imaging* / Q000473:pathology; D005260:Female; D006526:Hepatitis C / Q000150:complications; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods; D007459:Iodized Oil; D007472:Iohexol; D007479:Iopamidol; D008099:Liver / Q000000981:diagnostic imaging; D008103:Liver Cirrhosis / Q000000981:diagnostic imaging / Q000209:etiology / Q000473:pathology; D008113:Liver Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000556:secondary; D008297:Male; D008875:Middle Aged; D011169:Portal Vein / Q000000981:diagnostic imaging; D011172:Portography / Q000379:methods; D011856:Radiographic Image Enhancement / Q000379:methods*; D012680:Sensitivity and Specificity; D013997:Time Factors; D014057:Tomography, X-Ray Computed / Q000379:methods*
D003287:Contrast Media; D007472:Iohexol; D007459:Iodized Oil; D007479:Iopamidol