Advanced CT techniques for assessing hepatocellular carcinoma

Nakamura, Yuko; Higaki, Toru; Honda, Yukiko; Tatsugami, Fuminari; Tani, Chiara; Fukumoto, Wataru; Narita, Keigo; Kondo, Shota; Akagi, Morihisa; Awai, Kazuo

doi:10.1007/s11547-021-01366-4

Cited by 51 publications

(41 citation statements)

References 77 publications

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“…Hepatocellular carcinoma is mainly supplied by the hepatic artery, and in the early stage of enhancement, the CT value rises significantly and exceeds the liver parenchyma, showing early high-density enhancement, but the peak residence time of the lesion is short, after which the CT value of the lesion decreases, while the liver parenchyma reaches its peak in the portal vein phase, and the lesion is relatively with low density, with a fast-in and fast-out type of time density [ 15 ]. CT enhancement scanning improves the detection rate of hepatocellular carcinoma lesions by observing the dynamic process of contrast circulation in the liver [ 16 , 17 ], but there are deficiencies in all hepatocellular carcinoma lesions ≤3.0 cm in diameter, and clinical diagnosis requires attention [ 18 ].…”

Section: Discussionmentioning

confidence: 99%

The Value of Color Doppler Ultrasound and CT Combined with Serum AFP Examination in the Diagnosis of Hepatocellular Carcinoma

Jia

Mao

Liu

et al. 2022

Journal of Healthcare Engineering

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Objective. To evaluate the value of the combination of color Doppler ultrasound, computed tomography (CT), and serum tumor marker alpha-fetoprotein (AFP) examination in the diagnosis of hepatocellular carcinoma (HCC). Methods. 98 patients with HCC (malignant tumor group) and 50 liver lesion patients (benign control group), were selected for the study, and retrospective statistical methods were used to evaluate the diagnostic values of the three examinations on hepatocellular carcinoma. Results. (1) When comparing color Doppler ultrasound blood flow parameters, the hepatic artery diameter, peak flow velocity, minimum flow velocity, and resistance index (RI) of hepatocellular carcinoma were significantly higher than those of the benign control group ( P < 0.05 ), while the portal vein flow velocity was significantly lower than that of the control group ( P < 0.05 ). (2) Enhanced CT imaging of hepatocellular carcinoma lesions showed mostly outflow-type enhancement changes, with high- or slightly high-density shadowing and uneven enhancement in the arterial phase, relatively low density and withdrawal of enhancement in the portal vein phase and delayed phase. (3) The serum AFP level of hepatocellular carcinoma patients was significantly higher than that of the benign control group ( P < 0.01 ). (4) The sensitivity of color Doppler ultrasound, CT, and serum AFP alone for the diagnosis of HCC was 79.59%, 85.71%, and 66.33%, and the accuracy was 83.78%, 87.16%, and 74.32%, respectively, while the combination of the three tests could significantly increase the sensitivity to 96.94% and the accuracy to 93.92%, compared with each individual test ( P < 0.01 ). Conclusion. Color Doppler ultrasound and CT combined with serum AFP examination could significantly improve the sensitivity and accuracy of hepatocellular carcinoma diagnosis, reduce misdiagnosis, and facilitate early diagnosis and clinical early intervention.

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Section: Discussionmentioning

confidence: 99%

The Value of Color Doppler Ultrasound and CT Combined with Serum AFP Examination in the Diagnosis of Hepatocellular Carcinoma

Jia

Mao

Liu

et al. 2022

Journal of Healthcare Engineering

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“…The choice of modality (CT, US/CEUS or MRI) is correlated to patient, department, and regional features [ 50 , 51 , 51 , 93 – 106 ].…”

Section: Resultsmentioning

confidence: 99%

An update on radiomics techniques in primary liver cancers

Granata

Fusco

Setola

et al. 2022

Infect Agents Cancer

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Background Radiomics is a progressing field of research that deals with the extraction of quantitative metrics from medical images. Radiomic features detention indirectly tissue features such as heterogeneity and shape and can, alone or in combination with demographic, histological, genomic, or proteomic data, be used for decision support system in clinical setting. Methods This article is a narrative review on Radiomics in Primary Liver Cancers. Particularly, limitations and future perspectives are discussed. Results In oncology, assessment of tissue heterogeneity is of particular interest: genomic analysis have demonstrated that the degree of tumour heterogeneity is a prognostic determinant of survival and an obstacle to cancer control. Therefore, that Radiomics could support cancer detection, diagnosis, evaluation of prognosis and response to treatment, so as could supervise disease status in hepatocellular carcinoma (HCC) and Intrahepatic Cholangiocarcinoma (ICC) patients. Radiomic analysis is a convenient radiological image analysis technique used to support clinical decisions as it is able to provide prognostic and / or predictive biomarkers that allow a fast, objective and repeatable tool for disease monitoring. Conclusions Although several studies have shown that this analysis is very promising, there is little standardization and generalization of the results, which limits the translation of this method into the clinical context. The limitations are mainly related to the evaluation of data quality, repeatability, reproducibility, overfitting of the model. Trial registration: Not applicable.

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“…Different levels of monochromatic energy spectrum can meet the diagnostic needs of different diseases, and different energy spectral parameters have different applications for disease diagnosis and efficacy assessment [ 12 ]. Moreover, DECT has irreplaceable advantages in reducing X-ray sclerosis artifacts and CNR, optimized image quality and enhanced the display of hypovascular lesions, and benefited radiologists for disease diagnosis and lesion detection [ 4 ]. Studies have shown that tissue contrast increases significantly at low energy values; especially for hypervascular lesions, the enhanced contrast with surrounding normal tissues was vital, increasing the visibility of early-stage HCC lesions that were difficult to find in conventional enhanced CT [ 13 , 14 ].…”

Section: Discussionmentioning

confidence: 99%

“…Primary hepatocellular carcinoma (HCC) is the main pathotype of liver cancer, with insidious onset and prolonged course for many years, and most patients with HCC have chronic hepatitis and cirrhotic background. Early-stage HCC patients are always asymptomatic and have negative signs, and early-stage HCC is difficult to be detected by imaging on cirrhotic background [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

“…This result implied that imaging methods have an advantage in diagnostic sensitivity and specificity compared to laboratory tests, but some lesions still failed to meet the typical imaging criteria, and it was crucial to effectively differentiate typical HCC by imaging. Meanwhile, due to the subjectivity of radiologists in diagnosing HCC, there is often variation in the results of different readers, which directly leads to a strong dependence of imaging evaluation on the experience and expertise of the readers [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

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Dual‐Energy Computed Tomography Imaging in Early‐Stage Hepatocellular Carcinoma: A Preliminary Study

Zhao

Ling

et al. 2022

Contrast Media & Molecular Imaging

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Background. This study aims to evaluate the application of dual-energy computed tomography (DECT) for multiparameter quantitative measurement in early-stage hepatocellular carcinoma (HCC). Methods. The study retrospectively enrolled 30 patients with early-stage HCC and 43 patients with early-stage HCC who received radiofrequency ablation (RFA) and underwent abdomen enhanced CT scans in GSI mode. The GSI viewer was used for image display and data analysis. The regions of interest (ROIs) were delineated in the arterial phase and the venous phase. The optimal single energy value, CT values on different energy levels (40 keV, 70 keV, 100 keV, and 140 keV), the optimal energy level, the slope of the spectral attenuation curve, the effective atomic number (Zeff), iodine concentration (IC), water concentration (WC), normalized iodine concentration (NIC), and normalized water concentration (NWC) are measured and quantitatively analyzed. Results. The CT values of early-stage HCC at different single energy levels in dual phases were significantly different, and the single energy values were negatively correlated with the CT values. In the arterial phase and the venous phase, the optimal energy values for the best contrast-to-noise ratio were (68.34 ± 3.20) keV and (70.14 ± 2.01) keV, respectively. The slope of the spectral attenuation curve showed a downward trend at 40 keV, 70 keV, 100 keV, and 140 keV, but there was no statistically significant difference P > 0.05 . Zeff was positively correlated with IC and standardized IC, but has no significant correlation with WC and NWC in dual phases. Conclusion. DECT imaging contains multiparameter information and has different application values for early-stage HCC, and it is necessary to select the parameters reasonably for personalized and comprehensive evaluation.

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Advanced CT techniques for assessing hepatocellular carcinoma

Cited by 51 publications

References 77 publications

The Value of Color Doppler Ultrasound and CT Combined with Serum AFP Examination in the Diagnosis of Hepatocellular Carcinoma

The Value of Color Doppler Ultrasound and CT Combined with Serum AFP Examination in the Diagnosis of Hepatocellular Carcinoma

An update on radiomics techniques in primary liver cancers

Dual‐Energy Computed Tomography Imaging in Early‐Stage Hepatocellular Carcinoma: A Preliminary Study

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