Triple-Phase MDCT of Hepatocellular Carcinoma

Lee, K. H. Y.; O’Malley, Martin; Haider, Masoom A.; Hanbidge, Anthony

doi:10.2214/ajr.182.3.1820643

Cited by 80 publications

(46 citation statements)

References 23 publications

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“…10 lesions had capsular enhancement in delayed phase (76.9%). similar findings were described by Lee et al 17 9 cases had portal vein thrombosis (69.2%). Saini et al, has described that the tumor thrombus is another one of the characteristic features of HCC.…”

Section: Hepatocellular Carcinomasupporting

confidence: 89%

Role of triple phase computed tomography findings for evaluation of hepatic lesions

2016

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Section: Hepatocellular Carcinomasupporting

confidence: 89%

Role of triple phase computed tomography findings for evaluation of hepatic lesions

2016

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“…Several other imaging features can be used to distinguish HCC from other liver lesions: portal vein invasion, abnormal internal vessels [3,25], heterogeneous enhancement [3], large size [7], hyperintensity on T2 MRI sequences, and a pseudocapsule with delayed enhancement [26] all favor a diagnosis of HCC. Our findings should be confirmed with a prospective study, where the HAC and PVC are considered in the context of all of the other imaging and clinical data.…”

Section: Discussionmentioning

confidence: 99%

“…On triphasic CT, hepatocellular carcinoma (HCC) is characteristically hyperdense compared to the surrounding liver in the arterial phase, isodense or hypodense compared to the liver in the portal venous phase, and hypodense compared to the liver in the delayed phase [1,3]. Arterial phase enhancement (hyperdense compared to surrounding liver) with portal venous or delayed phase washout of contrast (hypodense compared to surrounding liver) [4] is considered diagnostic of HCC in cirrhotic livers, according to both European Association for the Study of the Liver (EASL) [5] and American Association for the Study of Liver Diseases (AASLD) [6] guidelines.…”

Section: Introductionmentioning

confidence: 99%

Classification of Hypervascular Liver Lesions Based on Hepatic Artery and Portal Vein Blood Supply Coefficients Calculated from Triphasic CT Scans

Boas

Kamaya

et al. 2014

J Digit Imaging

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Perfusion CT of the liver typically involves scanning the liver at least 20 times, resulting in a large radiation dose. We developed and validated a simplified model of tumor blood supply that can be applied to standard triphasic scans and evaluated whether this can be used to distinguish benign and malignant liver lesions. Triphasic CTs of 46 malignant and 32 benign liver lesions were analyzed. For each phase, regions of interest were drawn in the arterially enhancing portion of each lesion, as well as the background liver, aorta, and portal vein. Hepatic artery and portal vein blood supply coefficients for each lesion were then calculated by expressing the enhancement curve of the lesion as a linear combination of the enhancement curves of the aorta and portal vein. Hepatocellular carcinoma (HCC) and hypervascular metastases, on average, both had increased hepatic artery coefficients compared to the background liver. Compared to HCC, benign lesions, on average, had either a greater hepatic artery coefficient (hemangioma) or a greater portal vein coefficient (focal nodular hyperplasia or transient hepatic attenuation difference). Hypervascularity with washout is a key diagnostic criterion for HCC, but it had a sensitivity of 72 % and specificity of 81 % for diagnosing malignancy in our diverse set of liver lesions. The sensitivity for malignancy was increased to 89 % by including enhancing lesions that were hypodense on all phases. The specificity for malignancy was increased to 97 % (p=0.039) by also examining hepatic artery and portal vein blood supply coefficients, while maintaining a sensitivity of 76 %.

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“…She had a well-defined hypoechoic lesion in right lobe of liver. On histopathology lesion was diagnosed as HCC [13]. 9 cases had portal vein thrombosis (69.2%).…”

Section: Hepatocellular Carcinomamentioning

confidence: 99%

Role of ultrasonography to evaluate hepatic lesions

Ahirwar¹,

Patil²,

Soni³

2016

SJAMS

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Abstract:Characterizing a hepatic lesion as benign or malignant is very essential for correct therapeutic plan and surgical triage. USG plays crucial role in screening of a liver lesion. The aim is to study the characteristics of various hepatic lesions using USG, differentiating benign hepatic lesions from malignant and correlating features of USG findings with clinical, histopathology or post-operative findings. This is cross sectional hospital based study of 100 patients with clinical suspicion of liver pathology and hepatic masses. All patients underwent ultrasonography examination with subsequent follow up, histopathology correlation and accuracy, sensitivity and specificity of ultrasound for evaluation of hepatic lesions were calculated. Statistical analysis was done using computer software (SPSS IBM version 20).Qualitative data were expressed in proportion and percentages and quantitative data expressed as mean and standard deviations. Difference in proportion was analysed by using chi square test and difference in means were analysed by using student T Test [unpaired]. Significance level for tests was determined as 95%. Thus difference was significant if p <0.05. USG proved to be a good screening modality with a sensitivity of 82.7% , specificity 95.6 % , PPV 82.7 % and NPV 95.6 % (p value <0.001 , kappa value 0.678) . Malignant hepatic lesions can be diagnosed by USG with accuracy of 87 %, sensitivity and specificity of 90 % and 82.5 % respectively and PPV and NPV of 88.5 % and 84.6 % respectively. Ultrasonography must be performed in all patients with clinical suspicion of hepatic masses, for initial detection and localisation of lesions. It has high accuracy, sensitivity and specificity to characterize a lesion as benign or malignant. Also it is widely available, less expensive and with no radiation exposure.

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Triple-Phase MDCT of Hepatocellular Carcinoma

Cited by 80 publications

References 23 publications

Role of triple phase computed tomography findings for evaluation of hepatic lesions

Role of triple phase computed tomography findings for evaluation of hepatic lesions

Classification of Hypervascular Liver Lesions Based on Hepatic Artery and Portal Vein Blood Supply Coefficients Calculated from Triphasic CT Scans

Role of ultrasonography to evaluate hepatic lesions

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