title: Comparing the detectability of hepatocellular carcinoma by C-arm dual-phase cone-beam computed tomography during hepatic arteriography with conventional contrast-enhanced magnetic resonance imaging.
abstract: OBJECTIVE
  To evaluate the sensitivity of dual-phase cone-beam computed tomography during hepatic arteriography (CBCTHA) for the detection of hepatocellular carcinoma (HCC) by comparing it with the diagnostic imaging "gold standard": contrast-enhanced magnetic resonance imaging (CE-MRI) of the liver.
  
  
  METHODS
  Eighty-eight HCC lesions (mean diameter 3.9 ± 3.3 cm) in 20 patients (13 men, mean age 61.4 years [range 50 to 80]), who sequentially underwent baseline diagnostic liver CE-MRI and then underwent early arterial- and delayed portal venous-phase CBCTHA during drug eluting-bead transarterial chemoembolization, were evaluated. Dual-phase CBCTHA findings of each tumor in terms of conspicuity were compared with standard CE-MR images and classified into three grades: optimal, suboptimal, and nondiagnostic.
  
  
  RESULTS
  Seventy-seven (mean diameter 4.2 ± 3.4 cm [range 0.9 to 15.9]) (93.9%) of 82 tumors were detected. Sensitivity of arterial-phase (71.9%) was lower than that of venous-phase CBCTHA (86.6%) for the detection of HCC lesions. Of the 82 tumors, 33 (40.2%) and 52 (63.4%), 26 (31.7%) and 19 (23.2%), and 23 (28%) and 11 (13.4%) nodules were classed as optimal, suboptimal, and nondiagnostic on arterial- and venous-phase CBCTHA images, respectively. Seventeen (73.9%) of the 23 tumors that were not visible on arterial phase were detected on venous phase. Six (54.5%) of the 11 tumors that were not visible on venous phase were detected on arterial phase.
  
  
  CONCLUSIONS
  Dual-phase CBCTHA has sufficient image quality to detect the majority of HCC lesions compared with the imaging "gold standard": CE-MRI of the liver. Moreover, dual-phase CBCTHA is more useful and reliable than single-phasic imaging to depict HCC nodules.
authors.affiliation: Russell H. Morgan Department of Radiology and Radiological Science, Division of Vascular and Interventional Radiology, Johns Hopkins Hospital, Baltimore, MD, USA. romaric.loffroy@gmail.com
authors.forename: Romaric
authors.initials: R
authors.lastname: Loffroy
authors.forename: MingDe
authors.initials: M
authors.lastname: Lin
authors.forename: Pramod
authors.initials: P
authors.lastname: Rao
authors.forename: Nikhil
authors.initials: N
authors.lastname: Bhagat
authors.forename: Niels
authors.initials: N
authors.lastname: Noordhoek
authors.forename: Alessandro
authors.initials: A
authors.lastname: Radaelli
authors.forename: Järl
authors.initials: J
authors.lastname: Blijd
authors.forename: Jean-François
authors.initials: JF
authors.lastname: Geschwind
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000792:Angiography / Q000379:methods*; D006528:Carcinoma, Hepatocellular / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000628:therapy*; D016461:Chemoembolization, Therapeutic / Q000379:methods*; D054893:Cone-Beam Computed Tomography / Q000379:methods*; D003287:Contrast Media; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D008113:Liver Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000628:therapy*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012680:Sensitivity and Specificity
chemical_list: D003287:Contrast Media