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Hypervascular hepatocellular carcinoma: Combined dynamic MDCT and SPIO‐enhanced MRI versus combined CTHA and CTAP
Author(s) -
Imai Yasuharu,
Murakami Takamichi,
Hori Masatoshi,
Fukuda Kazuto,
Kim Tonsok,
Marukawa Taro,
Abe Hisashi,
Kuwabara Masatomo,
Onishi Hiromitu,
Tsuda Kyo,
Sawai Yoshiyuki,
Kurokawa Masanori,
Hayashi Norio,
Monden Morito,
Nakamura Hironobu
Publication year - 2008
Publication title -
hepatology research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.123
H-Index - 75
eISSN - 1872-034X
pISSN - 1386-6346
DOI - 10.1111/j.1872-034x.2007.00210.x
Subject(s) - hepatocellular carcinoma , medicine , radiology , magnetic resonance imaging , nuclear medicine , diagnostic accuracy , receiver operating characteristic , portography , dynamic contrast , portal hypertension , cirrhosis
Aim: Recently, many diagnostic modalities have been developed for the detection of hepatocellular carcinoma (HCC). Of these, a less invasive and more accurate diagnostic procedure is desirable. This study was undertaken to compare combined dynamic multidetector row helical computerized tomography (MDCT) and superparamagnetic iron oxide (SPIO)‐enhanced magnetic resonance imaging (MRI) with combined CT hepatic arteriography (CTHA) and CT during arterial portography (CTAP) for the detection of hypervascular HCC. Methods: Forty‐eight patients with 56 pathologically proved hypervascular HCCs (less than 5.0 cm in diameter) underwent dynamic MDCT and SPIO‐enhanced MRI, as well as CTHA and CTAP. The images were reviewed by four independent and blinded readers on a tumor‐by‐tumor basis. Results: The mean areas under alternative‐free response receiver operating characteristic curve (Az) for combined dynamic MDCT and SPIO‐enhanced MRI (IV set) and combinedCTHA and CTAP (IA set) were comparable (0.948 and 0.969, respectively, P > 0.05), although the Az value of the IV set was significantly lower than that of the IA set in HCCs smaller than or equal to 1.5 cm (0.867 and 0.937, respectively, P = 0.033). The mean sensitivity and positive predictive value of the IV set were similar to those of the IA set. Conclusions: Combined dynamic MDCT and SPIO‐enhanced MRI showed a diagnostic accuracy comparable to intra‐arterial contrast‐enhanced CT (CTHA and CTAP) for hypervascular HCC, and may be a useful diagnostic option prior to curative treatments of hypervascular HCC, although a limitation exists in detecting HCCs smaller than or equal to 1.5 cm.