Combined parenchymal and vascular imaging: High spatiotemporal resolution arterial evaluation of hepatocellular carcinoma.
OBJECTIVE
To assess the ability of high-resolution arterial phase imaging of hepatocellular carcinoma (HCC) to provide combined vascular characterization and parenchymal evaluation.


METHODS
Thirty-eight consecutive studies in cirrhotic patients with HCC scanned with a view-shared 2-point-Dixon-based Differential Subsampling with Cartesian Ordering (DISCO) sequence were analyzed. Lesion contrast relative to precontrast and adjacent parenchyma was evaluated and compared using a Fisher's exact test. Visibility of hepatic arteries and tumor feeding vessels were graded on a 5-point scale. Catheter angiography was used as a reference standard for arterial anatomy.


RESULTS
The high spatiotemporal multiphasic acquisition allowed imaging of both the angiographic and late arterial phase in 30 of 38 studies with good image quality. Maximal lesion enhancement compared to precontrast occurred more frequently during the late arterial phase compared to maximal lesion-to-adjacent, which occurred more frequently during the early arterial phase (P < 0.001). Common and proper hepatic arteries were visualized adequately in 100%, right hepatic artery in 94-97%, left hepatic artery in 94%, and segmental vessel in 83% of cases. Arterial variants were detected with sensitivity of 87-100% and specificity of 100%.


CONCLUSIONS
High spatiotemporal resolution arterial phase imaging provides multiple angiographic and arterial phases in a single breath-hold, enabling accurate depiction of vascular anatomy while maintain optimal arterial phase imaging for characterization of focal lesions.
Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California, USA.
Thomas A
TA
Hope
Department of Medical Imaging, University of Arizona College of Medicine, Tucson, Arizona, USA.
Iva
I
Petkovska
Department of Medical Imaging, University of Arizona College of Medicine, Tucson, Arizona, USA.|Department of Radiology, Stanford University School of Medicine, Stanford, California, USA.
Manojkumar
M
Saranathan
Department of Radiology, Stanford University School of Medicine, Stanford, California, USA.
Brian A
BA
Hargreaves
Department of Radiology, Stanford University School of Medicine, Stanford, California, USA.
Shreyas S
SS
Vasanawala
D000792:Angiography; D062485:Breath Holding; D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging* / Q000473:pathology; D003287:Contrast Media / Q000737:chemistry; D006499:Hepatic Artery / Q000473:pathology; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods; D007091:Image Processing, Computer-Assisted; D021621:Imaging, Three-Dimensional / Q000379:methods; D008099:Liver / Q000473:pathology; D008103:Liver Cirrhosis / Q000503:physiopathology; D008113:Liver Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D008279:Magnetic Resonance Imaging; D012015:Reference Standards; D012189:Retrospective Studies; D012680:Sensitivity and Specificity
D003287:Contrast Media
arterial mapping; hepatocellular carcinoma; high spatiotemporal resolution