Hypervascular Hepatocellular Carcinoma: Can Double Arterial Phase Imaging with Multidetector CT Improve Tumor Depiction in the Cirrhotic Liver?

Abstract

Double arterial phase CT with multidetector CT showed no significant improvement in effectiveness compared with single late arterial phase CT used alone for detecting hypervascular hepatocellular carcinoma in the cirrhotic liver.

CT and MR Imaging Diagnosis and Staging of Hepatocellular Carcinoma: Part I. Development, Growth, and Spread: Key Pathologic and Imaging Aspects

“…This phase coincides with peak arterial perfusion and enhancement of liver tumors, and it is critical for detection and characterization of hypervascular HCC (88) (Figs 2, 3). The early hepatic arterial phase, in which the hepatic artery is enhanced but the portal vein is not, is less effective, as tumor hypervascularity may be subtle or missed altogether (89). Most centers therefore omit the early hepatic arterial phase.…”

Focal Liver Lesions

“…Late arterial-phase imaging is the most sensitive for detecting small lesions [6,49,50]. A venous phase is always necessary for tumor detection/characterization and (Fig.…”

Diagnostic Imaging of Hepatocellular Carcinoma: Recent Progress

“…The artery-dominant phase is extremely important for the diagnosis of hypervascular HCC, but tumor staining is observed for only 7–19 s, and it can be difficult to scan the entire liver in the optimal artery-dominant phase using conventional helical CT. MDCT makes it possible to scan the entire liver multiple times during the artery-dominant phase, and the possibility of detecting tumor staining during the optimal phase has increased. Studies have also reported on the usefulness of double-arterial CT, which scans the early and late arterial phases [33,34], but subsequent studies by Ichikawa et al [35], Laghi et al [36], and Francis et al [37] failed to show any significant differences compared with the late arterial phase alone. …”