Helical CT versus CT arterial portography in the detection of hepatic metastasis of colorectal carcinoma.

Valls, Carlos; López, E.; Gumà, Anna; Gil, Mindy; Sánchez, Anna; Andía, Eduard; Serra, Javi; Moreno, Vı́ctor; Figueras, Juan

doi:10.2214/ajr.170.5.9574613

Cited by 82 publications

(25 citation statements)

References 28 publications

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“…The presence and locations of extracolonic metastases were recorded. The radiologists diagnosed extracolonic metastasis using previously published established criteria [15,16].…”

Section: Image Analysismentioning

confidence: 99%

The diagnostic value of multiplanar reconstruction on MDCT colonography for the preoperative staging of colorectal cancer

et al. 2006

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The purpose of this study was to determine whether multiplanar reconstruction (MPR) images can improve the accuracy of MDCT-based colorectal cancer preoperative staging by receiver-operating characteristic (ROC) analysis. Fifty-five patients with colorectal cancer underwent contrast-enhanced CT colonography using an 8- or 16-row scanner. Two separate interval reviews of the axial MDCT datasets with/without MPR images (coronal and sagittal) were performed independently by two radiologists blinded to both the colonoscopic and histopathologic results. At each review session, the radiologists were asked to determine the colorectal cancer TNM stage within the context of differentiating < or =T3 from T4, N0 from > or =N1 and M0 from M1 using a five-point confidence scale. The radiologists' performance for staging the colorectal cancer using axial CT datasets with/without MPR images was evaluated using ROC analysis. Sensitivities, specificities and interobserver agreement were assessed. When MPR images were added, significant improvement was achieved by both radiologists for differentiating N0 from > or =N1 in terms of both A(Z) (0.651 to 0.769; 0.573 to 0.713) and specificity (26.7 to 69.2%; 23.1 to 76.9%) (P<0.05). For T staging, ROC analysis failed to show a significant improvement in terms of differentiating < or =T3 from T4 for either radiologist (P>0.05), but a significant improvement in the specificity (70 to 90%; 80 to 92%) was achieved by one radiologist (P<0.05). In terms of the M staging, a significant improvement in the Az (0.844 to 0.996) was observed for the combined interpretation of the axial and MPR images by one radiologist (P<0.05). Furthermore, substantial or almost perfect interobserver agreement was achieved for all TNM stagings for the combined interpretations (kappa=0.641-0.866), whereas only fair to substantial agreement was achieved for the axial images alone (kappa=0.337-0.707). In conclusion, the combined interpretation of the axial and MPR MDCT images significantly improved the local staging of colorectal cancer compared with assessments based on axial images alone.

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“…The presence and locations of extracolonic metastases were recorded. The radiologists diagnosed extracolonic metastasis using previously published established criteria [15,16].…”

Section: Image Analysismentioning

confidence: 99%

The diagnostic value of multiplanar reconstruction on MDCT colonography for the preoperative staging of colorectal cancer

et al. 2006

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“…Underestimation of HCC extension results in early recurrence, and imaging procedures to detect tiny HCC lesions prior to treatment are important. Several studies have reported that CTAP is considered to be the most sensitive technique for the detection of hepatic tumors [13,14], however, this technique is costly, invasive and has a high false-positive rate [15,16]. There are several studies indicating that the combined use of CTAP and CTHA for patients with cirrhosis would be helpful in accurate diagnosis of small nodules [19][20][21][22], and is beneficial in the preoperative evaluation of patients with HCC [23].…”

Section: Discussionmentioning

confidence: 99%

“…Among these imaging techniques, CTAP is one of the most sensitive techniques available for detecting hemodynamic change [13,14], while its distinct disadvantages include invasiveness, high cost and a high rate of false-positive results [15,16]. We have frequently observed that some of the hepatic lesions identified by CTAP and/or CTHA in HCC patients are too small to be diagnosed as additional HCC lesions.…”

Section: Introductionmentioning

confidence: 99%

Outcome of small liver nodules detected by computed tomographic angiography in patients with hepatocellular carcinoma

et al. 2010

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Purpose Hepatic lesions identified by computed tomography (CT) during arterial portography (CTAP) or CT hepatic arteriography (CTHA) in hepatocellular carcinoma (HCC) patients are sometimes too small to be diagnosed as HCC. We undertook this cohort study to assess whether these small lesions are actually HCC, and to clarify the effectiveness of these imaging examinations in a clinical setting. Methods We assessed the characteristics of 74 tiny lesions detected by CTAP and/or CTHA, but not by CT in 67 patients. Results Seven out of 10 nodules were histologically confirmed as HCC and 18 out of 64 lesions increased in size and showed typical findings of HCC during the followup period. Multivariate analysis revealed that the size of the main tumor ([30 mm in diameter) was associated with the presence of tiny additional HCC lesions (P = 0.002). Conclusions These findings indicate that CTAP and CTHA are recommended for determining the stage of HCC, especially when the HCC nodule is larger than 30 mm in diameter.

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“…B. bei neu ro en dokri nen Tu mo ren, Nie ren zell-und Schilddrü senkar zi no men, Me la no men, Sar komen) und bei Ver dacht auf das Vor lie gen ei nes he pa to zel lu lä ren Kar zi noms so wie zur Cha rak te ri sie rung fo ka ler Le ber lä sionen die Durch füh rung ei ner 2-oder 3-Phasen,Spi ral,CT er for der lich. si ti ven Di ag no sen führ te [22,24]. Mit te der 1990er Jah re konn te erst mals ge zeigt wer den, dass die kon trast mit tel un ter stütz-te MRT im Ver gleich zur CTAP nicht nur eine hö he re Ge nau ig keit in der De tek ti on fo ka ler Le ber lä sio nen auf wies, son dern auch als nichtin va si ves Ver fah ren we sentlich preis güns ti ger ist [20].…”

Section: Abb 1 8 Dar Stel Lung Der Ge Fäß Ana To Mie Der Le Ber (A) unclassified

Moderne Bildgebung bei Lebermetastasen kolorektaler Tumoren

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et al. 2005

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Cross-sectional imaging modalities such as ultrasound, computed tomography (CT), magnetic resonance imaging (MRI), and Positron emission tomography (PET)/CT have benefited from rapid technical advances in recent years. In patients with colorectal tumors, multislice CT is the standard technique for preoperative evaluation and follow-up. It is faster than single-slice helical CT and allows for excellent 3D imaging of liver anatomy and tumor volumetry. The most accurate technique for detecting and characterizing focal liver lesions is MRI using state-of-the-art scanners and liver-specific contrast agents and should be used for preoperative evaluation of all possible surgical candidates. Whole-body FDG-PET and PET/CT are most useful in the detection of extrahepatic disease and may alter clinical management in up to 20% of patients by detecting extrahepatic spread of disease.

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Helical CT versus CT arterial portography in the detection of hepatic metastasis of colorectal carcinoma.

Cited by 82 publications

References 28 publications

The diagnostic value of multiplanar reconstruction on MDCT colonography for the preoperative staging of colorectal cancer

The diagnostic value of multiplanar reconstruction on MDCT colonography for the preoperative staging of colorectal cancer

Outcome of small liver nodules detected by computed tomographic angiography in patients with hepatocellular carcinoma

Moderne Bildgebung bei Lebermetastasen kolorektaler Tumoren

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