Detection of Corona Enhancement of Hypervascular Hepatocellular Carcinoma by C-Arm Dual-Phase Cone-Beam CT During Hepatic Arteriography

Abstract

The purpose of this study was to evaluate the detectability of corona enhancement around the hypervascular hepatocellular carcinoma (HCC) by dual-phase cone-beam computed tomography during hepatic arteriography (CBCTHA). Dual-phase CBCTHA was performed for 71 HCC lesions (mean ± SD 1.7 ± 0.9 cm), including seven presenting a nodule-in-nodule appearance and nine hypervascular pseudolesions. The first scan was performed during injection of 30-40 ml half-diluted contrast material at a rate of 1.5-2 ml/s through the hepatic artery. Scanning was initiated 7 s after the beginning of contrast material injection. The second scan was started 30 s after the end of the first scan. Detectability of corona enhancement on second-phase CBCTHA was evaluated. Thickness of corona enhancement was also analyzed as thin (≤2 mm) or thick (>2 mm). Corona enhancement was detected in 63 (88.7%) of 71 tumors (1.8 ± 0.9 cm), but it was not detected in eight tumors (1.0 ± 0.2 cm). Thin corona enhancement was seen in 18 tumors (1.2 ± 0.5 cm), and thick corona enhancement was seen in 45 tumors (2.0 ± 0.9 cm). There was a significant difference in tumor diameter between tumors with and those without corona enhancement (P = 0.0157) and between thin and thick corona enhancement (P = 0.001). In all seven early-stage tumors, corona enhancement was demonstrated around the hypervascular focus within the hypovascular tumor portion. None of the nine pseudolesions showed any corona enhancement. Dual-phase CBCTHA depicted corona enhancement in 88.7% of hypervascular HCC lesions. This technique may improve the diagnostic accuracy of HCC.

Diagnostic accuracy of C-arm CT during selective transcatheter angiography for hepatocellular carcinoma: comparison with intravenous contrast-enhanced, biphasic, dynamic MDCT

“…The field of view of the CACT image for axial sections was 25×25 cm 2 , and the matrix size was 256×256. The radiation dose of single CACT measured on a CT phantom was 22.3 mGy in the previous study [15].…”

Efficacy of cone-beam computed tomography during transcatheter arterial chemoembolization for hepatocellular carcinoma

“…This technique is currently being combined with TACE for HCC. [7][8][9][10][11][12] In this article, we describe the effi cacy of CBCT during TACE for HCC.…”

Ultrafast cone-beam computed tomography imaging and postprocessing data during image-guided therapeutic practice

“…There are many advantages during imaging of TACE patients using u-CBCT, such as shorter exposure time, which reduces long breath-hold during examinations; reduced contrast material volume compared with that reported in previous publications [4,6,15], and fewer image artefacts. Efficacy, sensitivity, accuracy, and ability to detect various hepatic lesions using CBCT have been extensively discussed [6,[15][16][17]. The ability to visualise various types of hepatic tumour enhancement after contrast-material injection is similar to that of multidetector CT, especially when biphasic arterial and portal venous or dual-phase CBCT are employed [16,17].…”

“…Reconstructed 3D image data may be necessary to locate tumours and also confirm the inserted intraarterial catheter tip during interventional procedures [4][5][6]. Furthermore, it raises the confidence of the procedural personnel.…”