Perfusion computed tomography for detection of hepatocellular carcinoma in patients with liver cirrhosis

Fischer, Michael A.; Kartalis, Nikolaos; Grigoriadis, Aristeidis; Loizou, Louiza; Stål, Per; Leidner, Bertil; Aspelin, Peter; Brismar, Torkel B.

doi:10.1007/s00330-015-3732-1

Cited by 48 publications

(27 citation statements)

References 40 publications

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“…Of the 53 participants from group A and B combined, 15 subjects have been previously reported on in other published studies (12,(15)(16)(17). However, the current study exploits a different study aim, methodology, and results as compared with the previous publications.…”

Section: Performance Of the Dose-equivalent Triple Arterial Phase Promentioning

confidence: 91%

“…However, the current study exploits a different study aim, methodology, and results as compared with the previous publications. Whereas previous studies dealt with perfusion CT of the liver and focused on technical refinements of the perfusion CT technique (15,17), as well as on diagnostic performance of perfusion mapping for the detection of HCC (12,16), the present study evaluates the feasibility, image quality, and diagnostic accuracy of a newly developed triple arterial phase CT liver protocol.…”

Section: Performance Of the Dose-equivalent Triple Arterial Phase Promentioning

confidence: 99%

“…Accordingly, the detection rate of HCC, especially when smaller than 2 cm, is poor at multiphasic CT and MRI (7)(8)(9), which might be due either to a weak arterial supply of early HCC or to suboptimal arterial phase timing of standard multiphasic imaging (10). Multiple arterial phase imaging with MRI (11), as well as arterial perfusion maps derived from several arterial time points of a CT perfusion study, have been shown to improve the sensitivity for detecting HCC (12), underlining the importance of accurate contrast material timing in HCC.…”

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confidence: 99%

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Triple Arterial Phase CT of the Liver with Radiation Dose Equivalent to That of Single Arterial Phase CT: Initial Experience

et al. 2018

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Purpose To develop and evaluate a triple arterial phase CT liver protocol with a similar radiation dose to that of standard single arterial phase CT in study subjects suspected of having hepatocellular carcinoma (HCC). Materials and Methods The study consisted of a retrospective part A for protocol development (n = 15) and a prospective part B to evaluate diagnostic accuracy (n = 38). All 53 participants underwent perfusion CT with 50 mL contrast material between August 2013 and September 2014. Group B underwent an additional standard multiphasic liver CT examination with 120 mL of contrast material (range, 70-143 mL). Image sets from triple arterial phase imaging were reconstructed from perfusion CT by fusing images from three dedicated arterial time points. Triple arterial phase CT and standard single arterial phase CT were compared by two readers, who assessed subjective image quality and HCC detection rate. A third reader served as reference reader and assessed objective image quality. The paired Student t test, Wilcoxon signed rank test, jackknife alternative free-response receiver operating characteristic (JAFROC), and JAFROC curve were applied. Results The mean volume CT dose index was 11.6 mGy for triple arterial phase CT and 11.9 mGy for standard single arterial phase CT (P = .73). Triple arterial phase CT showed lower image noise and better contrast-to-noise ratio compared with standard single arterial phase CT (P < .001 and P = .032, respectively); however, there was no significant difference in lesion-to-liver-contrast ratio (P = .31). Subjective image quality was good for both protocols. The detection rate of the 65 HCC lesions was 82% for reader 1 and 83% for reader 2 at triple arterial phase CT and 80% for reader 1 and 77% for reader 2 at standard single arterial phase CT (P = .4). Conclusion Triple arterial phase imaging is feasible at the same radiation dose as that used for standard single arterial phase CT. Triple arterial phase imaging provides equivalent to superior image quality and equal HCC detection rate despite the use of less than half the contrast material dose used at standard single arterial phase CT. © RSNA, 2018.

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Section: Performance Of the Dose-equivalent Triple Arterial Phase Promentioning

confidence: 91%

Section: Performance Of the Dose-equivalent Triple Arterial Phase Promentioning

confidence: 99%

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confidence: 99%

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Triple Arterial Phase CT of the Liver with Radiation Dose Equivalent to That of Single Arterial Phase CT: Initial Experience

et al. 2018

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“…Our CT protocol was for preoperative evaluation of hepatic lesions and liver vascular anatomy as well as for perfusion analysis by a 64-row detector CT scanner, so the temporal resolution in our CT protocol was lower than in usual perfusion imaging. [19][20][21][22] However, it was high enough to evaluate the differences among patients with different stages of liver fibrosis. This is mainly because the pharmacokinetic model of the spleen is simpler than that of the liver for evaluating perfusion parameters, as explained above.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of splenic perfusion and spleen size using dynamic computed tomography: Usefulness in assessing degree of liver fibrosis

Suzuki

Yamada

Komatsu

et al. 2017

Hepatology Research

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Aim:To enhance the usefulness of splenic perfusion evaluated by means of dynamic computed tomography (CT) and spleen size in assessing the degree of liver fibrosis. Methods:We retrospectively studied 133 patients who had undergone dynamic CT before hepatectomy. Fibrosis was histologically established in all. First we calculated splenic perfusion parameters K 1 (inflow rate constant), 1/k 2 (mean transit time; MTT), and K 1 /k 2 (distribution volume; V d ), using compartment model analysis. Then we compared the stage of fibrosis with splenic perfusion and spleen size (long axis, R), using the Kruskal-Wallis test and multiple comparisons. After that, we assessed the diagnostic accuracy of the combination of splenic perfusion, spleen size, age, gender, and the presence or absence of hepatitis B and hepatitis C viral infection in detecting liver fibrosis, using stepwise regression and receiver operating characteristic analysis.Results: Significant differences (P < 0.05) in MTT were observed in comparisons between fibrosis stages F0 and F4, between F1 and F4, and between F2 and F4. Significant differences (P < 0.05) in R were observed in comparisons between F0 and F4, and between F1 and F4. Considering the presence or absence of hepatitis B and C viral infection along with MTT and R, the areas under the receiver operating characteristic curves were 0.89 for ≥F1, 0.83 for ≥F2, 0.82 for ≥F3, and 0.82 for F4.Conclusion: Splenic MTT and spleen size are helpful in assessing liver fibrosis.

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“…Thus, analysis of perfusion maps might increase the sensitivity for detection of HCC ( Fig. 3) [58]. Perfusion parameters (evaluated by perfusion CT) were also shown to correlate with tumour differentiation, with well-differentiated HCC having significantly higher perfusion values than other grades [59].…”

Section: Added Value Of Perfusion Imaging In Primary Liver Tumoursmentioning

confidence: 99%

Functional imaging in liver tumours

Ronot

Clift

Vilgrain

et al. 2016

Journal of Hepatology

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Functional imaging encompasses techniques capable of assessing physiological parameters of tissues, and offers useful clinical information in addition to that obtained from morphological imaging. Such techniques may include magnetic resonance imaging with diffusion-weighted sequences or hepatobiliary contrast agents, perfusion imaging, or molecular imaging with radiolabelled tracers. The liver is of major importance in oncological practice; not only is hepatocellular carcinoma one of the malignancies with steadily rising incidence worldwide, but hepatic metastases are regularly observed with a range of solid neoplasms. Within the realm of hepatic oncology, different functional imaging modalities may occupy pivotal roles in lesion characterisation, treatment selection and follow-up, depending on tumour size and type. In this review, we characterise the major forms of functional imaging, discuss their current application to the management of patients with common primary and secondary liver tumours, and anticipate future developments within this field.

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Perfusion computed tomography for detection of hepatocellular carcinoma in patients with liver cirrhosis

Cited by 48 publications

References 40 publications

Triple Arterial Phase CT of the Liver with Radiation Dose Equivalent to That of Single Arterial Phase CT: Initial Experience

Triple Arterial Phase CT of the Liver with Radiation Dose Equivalent to That of Single Arterial Phase CT: Initial Experience

Evaluation of splenic perfusion and spleen size using dynamic computed tomography: Usefulness in assessing degree of liver fibrosis

Functional imaging in liver tumours

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