Comparing the detectability of hepatocellular carcinoma by C-arm dual-phase cone-beam computed tomography during hepatic arteriography with conventional contrast-enhanced magnetic resonance imaging

Romaric Loffroy, Mingde Lin, Pramod Rao, Nikhil Bhagat, Niels Noordhoek, Alessandro Radaelli, Järl Blijd, Jean François Geschwind

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose: To evaluate the sensitivity of dual-phase cone-beam computed tomography during hepatic arteriography (CBCTHA) for the detection of hepatocellular carcinoma (HCC) by comparing it with the diagnostic imaging "gold standard": contrast-enhanced magnetic resonance imaging (CE-MRI) of the liver. Materials and Methods: Eighty-eight HCC lesions (mean diameter 3.9 ± 3.3 cm) in 20 patients (13 men, mean age 61.4 years [range 50 to 80]), who sequentially underwent baseline diagnostic liver CE-MRI and then underwent early arterial- and delayed portal venous-phase CBCTHA during drug eluting-bead transarterial chemoembolization, were evaluated. Dual-phase CBCTHA findings of each tumor in terms of conspicuity were compared with standard CE-MR images and classified into three grades: optimal, suboptimal, and nondiagnostic. Results: Seventy-seven (mean diameter 4.2 ± 3.4 cm [range 0.9 to 15.9]) (93.9%) of 82 tumors were detected. Sensitivity of arterial-phase (71.9%) was lower than that of venous-phase CBCTHA (86.6%) for the detection of HCC lesions. Of the 82 tumors, 33 (40.2%) and 52 (63.4%), 26 (31.7%) and 19 (23.2%), and 23 (28%) and 11 (13.4%) nodules were classed as optimal, suboptimal, and nondiagnostic on arterial- and venous-phase CBCTHA images, respectively. Seventeen (73.9%) of the 23 tumors that were not visible on arterial phase were detected on venous phase. Six (54.5%) of the 11 tumors that were not visible on venous phase were detected on arterial phase. Conclusions: Dual-phase CBCTHA has sufficient image quality to detect the majority of HCC lesions compared with the imaging "gold standard": CE-MRI of the liver. Moreover, dual-phase CBCTHA is more useful and reliable than single-phasic imaging to depict HCC nodules.

Original languageEnglish (US)
Pages (from-to)97-104
Number of pages8
JournalCardiovascular and interventional radiology
Volume35
Issue number1
DOIs
StatePublished - Feb 1 2012

Keywords

  • Angiography
  • C-arm cone-beam CT
  • Drug eluting-beads
  • Hepatocellular carcinoma
  • Magnetic resonance imaging
  • Transarterial chemoembolization

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

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