Postablation assessment of hepatocellular carcinoma using dual-energy CT: Comparison of half versus standard iodine contrast medium

Abstract

This retrospective study was aimed to evaluate the reduced iodine load on image quality and diagnostic performance in multiphasic hepatic CT using a novel monoenergetic reconstruction algorithm (nMERA) in assessment of local tumor progression after radiofrequency ablation (RFA) of hepatocellular carcinoma (HCC). Ninety patients who underwent CT 1 month after RFA of HCC. Forty-five patients had multiphasic hepatic dual-energy CT with a half-reduced contrast medium (HRCM) of 277.5 mg I/kg. The nMERA (40–70-keV) images were reconstructed in each phase. Another 45 patients received a standard contrast medium (SCM) of 555 mg I/kg, and the images were reconstructed as a simulated 120-kVp images. Primary outcome was accuracy, sensitivity, specificity, and area under the receiver operating characteristic curve (AUC) in assessment of local tumor progression. Additional advanced assessments included the image noise, attenuation value, contrast-to-noise ratio (CNR), and subjective image quality between the groups. The accuracy, sensitivity and specificity of nMERA HRCM images were 95.7%, 100% and 93.9% for 40 keV, 95.7%, 85.7% and 100% for 50 keV, 83.0%, 42.8% and 100% for 60 keV, and 83.0%, 42.9% and 100% for 70 keV. The AUROC was 0.99, 0.99, 0.94, and 0.93 for 40–70 keV nMERA HRCM images, respectively. Compared with simulated 120-kVp SCM images, nMERA HRCM images demonstrated comparable noise at 70-keV (P < 0.05), and comparable CNR at 40- and 50-keV (P < 0.05). nMERA DECT enables the contrast medium to be reduced to up to 50% in multiphasic hepatic CT while preserving diagnostic accuracy.

The clinical value of dual‐energy computed tomography and diffusion‐weighted imaging in the context of liver cancer: A narrative review

“…DECT not only has better diagnostic performance but also presents surprising advantages compared with conventional CT, particularly in terms of contrast and radiation dose. 16,17 This is because it allows for the reconstruction of virtual monoenergetic imaging by combining two different datasets (obtained by low-and high-energy tubes).…”

Survival prediction of hepatocellular carcinoma by measuring the extracellular volume fraction with single-phase contrast-enhanced dual-energy CT imaging

“…In previous studies (8)(9)(10)(11), dual-energy CT (DECT) scanning has been proven to be effective and quantitative in evaluating the prognosis of HCC patients after treatment. At the same time, other relevant studies have shown that extracellular volume fraction (fECV) based on the iodine density of DECT scanning can quantify the liver extracellular volume and early identify patients with high risk for developing liver-related adverse events (12-15).…”

Baohuoside I Inhibits the Proliferation of Hepatocellular Carcinoma Cells via Apoptosis Signaling and NF‐kB Pathway

“…Hepatocellular carcinoma (HCC) is one of the most aggressive and lethal cancer among different cancers, with five‐year overall survival of approximately 10 to 15 %. It is now regarded as the third most common cause of cancer‐related death [1,2] . Considerable progress has been made in diagnosis, surgery, and treatment over the past few decades for the HCC treatment.…”