OBJECTIVES: To investigate the value of CT spectral imaging in differentiating hepatocellular carcinoma (HCC) from focal nodular hyperplasia (FNH) during the arterial phase (AP) and portal venous phase (PP). METHODS: Fifty-eight patients with 42 HCCs and 16 FNHs underwent spectral CT during AP and PP. The lesion-liver contrast-to-noise ratio (CNR) at different energy levels, normalised iodine concentrations (NIC) and the lesion-normal parenchyma iodine concentration ratio (LNR) were calculated. The two-sample t test compared quantitative parameters. Two readers qualitatively assessed lesion types according to imaging features. Sensitivity and specificity of the qualitative and quantitative studies were compared. RESULTS: In general, CNRs at low energy levels (40-70 keV) were higher than those at high energy levels (80-140 keV). NICs and LNRs for HCC differed significantly from those of FNH: mean NICs were 0.25 mg/mL ± 0.08 versus 0.42 mg/mL ± 0.12 in AP and 0.52 mg/mL ± 0.14 versus 0.86 mg/mL ± 0.18 in PP. Mean LNRs were 2.97 ± 0.50 versus 6.15 ± 0.62 in AP and 0.99 ± 0.12 versus 1.22 ± 0.26 in PP. NICs and LNRs for HCC were lower than those of FNH. LNR in AP had the highest sensitivity and specificity in differentiating HCC from FNH. CONCLUSIONS: CT spectral imaging may help to increase detectability of lesions and accuracy of differentiating HCC from FNH. KEY POINTS: • CT spectral imaging may help to detect hepatocellular carcinoma (HCC). • CT spectral imaging may help differentiate HCC from focal nodular hyperplasia. • Quantitative analysis of iodine concentration provides greater diagnostic confidence. • Treatment can be given with greater confidence.
OBJECTIVES: To investigate the value of CT spectral imaging in differentiating hepatocellular carcinoma (HCC) from focal nodular hyperplasia (FNH) during the arterial phase (AP) and portal venous phase (PP). METHODS: Fifty-eight patients with 42 HCCs and 16 FNHs underwent spectral CT during AP and PP. The lesion-liver contrast-to-noise ratio (CNR) at different energy levels, normalised iodine concentrations (NIC) and the lesion-normal parenchyma iodine concentration ratio (LNR) were calculated. The two-sample t test compared quantitative parameters. Two readers qualitatively assessed lesion types according to imaging features. Sensitivity and specificity of the qualitative and quantitative studies were compared. RESULTS: In general, CNRs at low energy levels (40-70 keV) were higher than those at high energy levels (80-140 keV). NICs and LNRs for HCC differed significantly from those of FNH: mean NICs were 0.25 mg/mL ± 0.08 versus 0.42 mg/mL ± 0.12 in AP and 0.52 mg/mL ± 0.14 versus 0.86 mg/mL ± 0.18 in PP. Mean LNRs were 2.97 ± 0.50 versus 6.15 ± 0.62 in AP and 0.99 ± 0.12 versus 1.22 ± 0.26 in PP. NICs and LNRs for HCC were lower than those of FNH. LNR in AP had the highest sensitivity and specificity in differentiating HCC from FNH. CONCLUSIONS: CT spectral imaging may help to increase detectability of lesions and accuracy of differentiating HCC from FNH. KEY POINTS: • CT spectral imaging may help to detect hepatocellular carcinoma (HCC). • CT spectral imaging may help differentiate HCC from focal nodular hyperplasia. • Quantitative analysis of iodine concentration provides greater diagnostic confidence. • Treatment can be given with greater confidence.
Authors: Shahid M Hussain; Türkan Terkivatan; Pieter E Zondervan; Esmée Lanjouw; Sjoerd de Rave; Jan N M Ijzermans; Rob A de Man Journal: Radiographics Date: 2004 Jan-Feb Impact factor: 5.333
Authors: J M Langrehr; R Pfitzmann; M Hermann; C Radke; P Neuhaus; M Pech; T Denecke; R Felix; E L Hänninen Journal: Acta Radiol Date: 2006-05 Impact factor: 1.990
Authors: M Hayashi; O Matsui; K Ueda; Y Kawamori; M Kadoya; J Yoshikawa; T Gabata; T Takashima; A Nonomura; Y Nakanuma Journal: AJR Am J Roentgenol Date: 1999-04 Impact factor: 3.959
Authors: Lucas L Geyer; Michael Scherr; Markus Körner; Stefan Wirth; Paul Deak; Maximilian F Reiser; Ulrich Linsenmaier Journal: Eur J Radiol Date: 2011-03-21 Impact factor: 3.528
Authors: J Yoshikawa; O Matsui; T Takashima; M Ida; T Takanaka; I Kawamura; K Kakuda; S Miyata Journal: AJR Am J Roentgenol Date: 1988-10 Impact factor: 3.959
Authors: Dagmar Högemann Savellano; Herbert Köstler; Stefan Baus; Meike Mössinger; Klaus Friedrich Gratz; Arved Weimann; Michael Galanski Journal: Invest Radiol Date: 2004-05 Impact factor: 6.016
Authors: Carlo N De Cecco; Damiano Caruso; U Joseph Schoepf; Domenico De Santis; Giuseppe Muscogiuri; Moritz H Albrecht; Felix G Meinel; Julian L Wichmann; Philip F Burchett; Akos Varga-Szemes; Douglas H Sheafor; Andrew D Hardie Journal: Eur Radiol Date: 2018-02-19 Impact factor: 5.315