Differentiation of Small Hepatic Hemangioma from Small Hepatocellular Carcinoma: Recently Introduced Spectral CT Method

Lv, Peijie; Xiang, Lin; Li, Jianying; Li, Weixia; Chen, Kemin

doi:10.1148/radiol.11101425

Cited by 193 publications

(153 citation statements)

References 17 publications

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“…Increasing the periodic testing of hepatitis B patients, especially those with cirrhosis, can promote the early detection, diagnosis, and treatment of SHCC, and determine the prognosis (11,12). At present, the definition of SHCC has no unified standard, and the criteria used in this study were as follows: The maximum diameter of single cancerous node, ≤3 cm; the number of cancerous nodes, ≤2; and the sum of maximum diameter, ≤3 cm (13). SHCC is closely related to various forms of chronic hepatitis and cirrhosis, and develops from liver cirrhosis.…”

Section: Discussionmentioning

confidence: 99%

Study on the diagnosis of small hepatocellular carcinoma caused by hepatitis B cirrhosis via multi‑slice spiral CT and MRI

et al. 2017

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Abstract. The present study compared the diagnostic accuracy of multi-slice spiral computed tomography (CT) and magnetic resonance imaging (MRI) on small hepatocellular carcinoma (SHCC) caused by hepatitis B cirrhosis. A total of 160 patients with hepatitis B cirrhosis were selected between January 2012 and April 2016, and 183 SHCC lesions were included in the present retrospective study. Patients were divided into the SHCC group (T stage) and the micro hepatocellular carcinoma (MHCC) group (T1 stage). There were a total of 129 SHCC lesions and 54 MHCC lesions identified. All patients underwent multiphasic CT and MRI imaging. The liver acquisition with volume acquisition (LAVA) technique was utilized for MRI. Furthermore, SPSS 20.0 was used for statistical analyses. LAVA in the arterial phase and CT in the arterial phase revealed significantly higher diagnostic rates for the diagnoses of 183 lesions. In addition, standard CT scan exhibited significantly reduced diagnostic rates in SHCC lesions. Results indicated that LAVA in the equilibrium phase had the lowest diagnostic rate in MHCC lesions, which was statistically significant (P<0.05). Overall, the diagnostic rate of CT (79.63%) for MHCC was significantly lower than that of MRI (96.29%) (P<0.05). However, the diagnostic rate of CT for SHCC (96.12%) was significantly higher than that for MHCC (79.63%) (P<0.05). MRI-LAVA in the arterial phase has the highest diagnostic rate for SHCC and MHCC. However, the diagnostic capability of MRI for MHCC lesions is superior to that of CT. IntroductionLiver cancer is one of the most common malignant tumors of the digestive system. It has high incidence rates and ranks second in cancer mortality in China (1). It has multiple causes, such as liver cirrhosis, viral infection, chemical carcinogens, alcohol and tobacco, water pollution, and genetic factors (2). Liver cancer caused by hepatitis B infection and cirrhosis is highly prevalent, although it lacks the typical clinical manifestations of liver cancer Moreover, it is particularly important to improve the diagnostic rate of early liver cancer (3). The clinical diagnosis of the hepatocellular cancer involves multiple approaches. Important clinical symptoms like abdominal distension, liver pain, fever, emaciation, debilitation, and jaundice confirms the middle and advanced stage of the disease. The clinically well-established factor being utilized for liver cancer is cirrhosis (4). The diagnosis of hepatocellular carcinoma could frequently, and uniquely, be made on characteristic multiphase contrast based cross-sectional imaging rather than strict need for tissue sampling. Epigentics is another new area showing good potential in clincal diagnosis of liver cancer. Promising results from microRNA (miRNA/miR) profiling and hypermethylation of selected genes have raised hopes of identifying new biomarkers (5). Furthermore, miR-122, a completely conserved liver-specific miRNA in vertebrates, is essential for the maintenance of liver homeostasis. miR-122 is also being explored for...

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Section: Discussionmentioning

confidence: 99%

Study on the diagnosis of small hepatocellular carcinoma caused by hepatitis B cirrhosis via multi‑slice spiral CT and MRI

et al. 2017

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“…Although our statistical analysis revealed no significant difference in the areas under the receiver operating characteristic curve between the quantitative and qualitative analyses, this finding was probably due to the small sample size used in this study. The values for the quantitative parameters represented improvements over the qualitative research data acquired by Lv et al, 11 who found that qualitative evaluations of the degree and/or pattern of enhancement were specific but not sensitive. An optimal cut-off point for these parameters should be derived to maximize both sensitivity and specificity.…”

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confidence: 82%

Evaluation of neovascularization with spectral computed tomography in a rabbit VX2 liver model: a comparison with real-time contrast-enhanced ultrasound and molecular biological findings

Zhou¹,

Gao²,

Han³

et al. 2015

BJR

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Objective: To validate the feasibility of using the parameters of spectral CT and CT perfusion and the dynamic features of real-time contrast-enhanced ultrasound (CEUS) to evaluate the vascularization of VX2 hepatic tumours. Methods: Spectral CT imaging, CT perfusion and CEUS analysis were performed on rabbits implanted with VX2 hepatic tumours, 7 and 14 days after implantation. The perfusion parameters of CT, normalized iodine concentration (NIC) and dynamic features of CEUS were measured in the rim of the tumour (TR) and the normal liver region. The expression of vascular endothelial growth factor (VEGF) and fibroblast growth factor 2 (FGF2) was also determined. Results: Increased perfusion parameters of CT were found in the TR. In addition, the NIC was elevated in TR during the arterial phase, and the peak intensity of the CEUS of the TR was reached significantly earlier than that on normal liver region. At 14 days, the perfusion parameters of CT (blood volume, permeability surface and hepatic arterial fraction) offered higher accuracy and stability in differentiating the TR from the normal liver region. Furthermore, CEUS was more accurate in diagnosing tumours ,1.0 cm in diameter. In addition, VEGF and FGF2 expression was higher in the TR and were positively correlated with CT and CEUS parameters, except mean transit time, rise time, washout time and peak time. Conclusion: Use of spectral CT with perfusion techniques, iodine-based material-decomposition analysis and dynamic CEUS changes may reflect the angiogenesis and haemodynamic information of hepatic tumours. Advances in knowledge: It is feasible to assess vascularization in hepatic cancer using CT or CEUS. INTRODUCTIONPrimary hepatic carcinoma is one of the most common malignant tumours, with a steadily increasing mortality rate over the past few years. 1 The newly emerging techniques of spectral CT imaging and CT perfusion reveal the haemodynamic features in the tumour tissues and play an important role in the detection and differential diagnosis of a solid mass in the liver.2,3 Dual-energy CT performed during two consecutive scans or with a dual X-ray source or dual-detector assembly has existed for a number of years. It was demonstrated that the additional information was provided by using dual-energy material separation technique, which had potential clinical applications.4,5 By revealing the blood supply and the haemodynamic features of the tumours, the real-time contrast-enhanced ultrasound (CEUS) provides high accuracy and specificity for diagnosing small hepatic tumours and enables the detection of early malignant diseases.

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“…The thickness change was calculated by subtracting the thickness at the last scan time point from the thickness at the current time point. In order to avoid the interference of various factors other than blood flow in the assay of iodine concentration, we normalized the DIC using a new indicator-normalized difference in iodine concentration (NDIC) according to the report of Lv et al, 10 by dividing the DIC of observed tissues by the iodine concentration in the aorta at the SMAE level. CT enhancement value-time curve, NDIC-time curve and thickness of intestine wall-time curve were drawn, respectively.…”

Section: Image Evaluationmentioning

confidence: 99%

Imaging of acute superior mesenteric artery embolus using spectral CT in a canine model

Wang

Xiang-sheng

Zhang

et al. 2015

BJR

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Objective: To explore the diagnostic value of single-source dual-energy spectral CT (sDECT) imaging in an acute superior mesenteric artery embolus (SMAE) canine model. Methods: Pre-contrast and double-phase contrastenhanced sDECT were performed before and after embolization in eight SMAE dog models. Monochromatic images of embolized intestine with the best contrastto-noise ratio (CNR) were obtained and compared with the polychromatic images. CT parameters including attenuation value, iodine content, water content and thickness of the embolized intestinal segments were obtained, and normalized difference in iodine concentration (NDIC) was calculated. Results: The CNR in pre-contrast, arterial phase and portal venous phase at 4 h after embolization was 1.11 6 1.23, 13.50 6 1.54 and 10.63 6 3.75, respectively, significantly higher than those of the polychromatic images (p , 0.05).The iodine-based images clearly revealed the embolized intestinal segments, which were highly consistent with the gross findings. The difference in attenuation values between the embolization area and non-embolization area in the monochromatic images was 105.06 6 35.35 HU, higher than that in the polychromatic images (p , 0.001). The attenuation values and NDIC were significantly decreased at 2 h after embolization, relatively increased at 4 h and gradually decreased at 6 and 8 h. The changing pattern of thickness was similar to that of NDIC over time after embolization. Conclusion: sDECT can provide the optimal monochromatic images and allow increased detection rates of lesions. sDECT is a very promising tool for quantitative diagnosis of SMAE. Advances in knowledge: Our research provides more quantitative parameters for the assessment of SMAE by sDECT.

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Differentiation of Small Hepatic Hemangioma from Small Hepatocellular Carcinoma: Recently Introduced Spectral CT Method

Abstract: Use of spectral CT with fast tube voltage switching may increase the sensitivity for differentiating small hemangiomas from small HCCs in two-phase scanning.

Cited by 193 publications

References 17 publications

Study on the diagnosis of small hepatocellular carcinoma caused by hepatitis B cirrhosis via multi‑slice spiral CT and MRI

Study on the diagnosis of small hepatocellular carcinoma caused by hepatitis B cirrhosis via multi‑slice spiral CT and MRI

Evaluation of neovascularization with spectral computed tomography in a rabbit VX2 liver model: a comparison with real-time contrast-enhanced ultrasound and molecular biological findings

Imaging of acute superior mesenteric artery embolus using spectral CT in a canine model

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