Literature DB >> 30017280

Iodine quantification to distinguish hepatic neuroendocrine tumor metastasis from hepatocellular carcinoma at dual-source dual-energy liver CT.

Benjamin Kaltenbach1, Julian L Wichmann2, Sophia Pfeifer1, Moritz H Albrecht1, Christian Booz1, Lukas Lenga1, Renate Hammerstingl1, Tommaso D'Angelo1, Thomas J Vogl1, Simon S Martin1.   

Abstract

PURPOSE: To investigate the value of third-generation dual-source dual-energy computed tomography (DECT) iodine quantification to distinguish hepatic neuroendocrine tumor (NET) metastasis from hepatocellular carcinoma (HCC) in non-cirrhotic liver parenchyma.
MATERIAL AND METHODS: Forty-six patients (mean age, 64.9 ± 10.1 years; 28 male and 18 female) with either hepatic NET metastasis or HCC, who had undergone liver DECT, were included in this retrospective study. For each lesion, arterial-phase attenuation values and DECT quantitative parameters, including iodine uptake, fat fraction, normalized iodine uptake (NIU), and lesion-to-liver-parenchyma ratio (LPR) were evaluated. Available cumulative data from histopathology, MRI, PET/CT, or interval imaging follow-up served as the reference standard for all liver lesions. In addition, the diagnostic accuracy of contrast-enhanced and material decomposition analysis for the differentiation of hepatic NET metastasis and HCC was assessed using receiver operating characteristics (ROC) curve analysis.
RESULTS: Hepatic NET metastasis and HCC showed significant differences in arterial attenuation (P = 0.003), iodine uptake (P < 0.001), NIU (P < 0.001), and LPR (P = 0.003). No significant differences were found for unenhanced attenuation and fat fraction values (P = 0.686 and P = 0.892, respectively). NIU showed superior sensitivity (100%; iodine uptake, 71%), while both iodine uptake and NIU revealed superior specificity (100% and 90%, respectively) compared to LPR (sensitivity, 96%; specificity, 80%) and arterial attenuation analysis (sensitivity, 79%; specificity, 80%) (P ≤ 0.016).
CONCLUSION: Third-generation DECT with assessment of iodine uptake improves the differentiation of hepatic NET metastasis and HCC in non-cirrhotic liver, with NIU showing the strongest diagnostic performance.
Copyright © 2018 Elsevier B.V. All rights reserved.

Entities:  

Keywords:  Dual-energy CT; Hepatocellular carcinoma; Iodine quantification; Liver imaging; Neuroendocrine tumors

Mesh:

Substances:

Year:  2018        PMID: 30017280     DOI: 10.1016/j.ejrad.2018.05.019

Source DB:  PubMed          Journal:  Eur J Radiol        ISSN: 0720-048X            Impact factor:   3.528


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