Evaluation of hypervascular hepatocellular carcinoma in cirrhotic liver: comparison of different concentrations of contrast material with multi-detector row helical CT--a prospective randomized study

Eur J Radiol. 2011 Dec;80(3):e237-42. doi: 10.1016/j.ejrad.2010.10.006. Epub 2010 Nov 9.

Abstract

Purpose: To evaluate two different iodine concentrations of contrast material for detecting hypervascular hepatocellular carcinomas (HCCs) in cirrhotic liver by multi-detector row helical CT (MDCT) when a fixed contrast material volume and injection rate is used.

Materials and methods: Institutional Review Board approval was obtained, and informed consent was obtained from all patients. In this prospective study, 105 patients were randomly assigned a group A (an iodine concentration of 300 mg I/mL), and a group B (an iodine concentration of 370 mg I/mL). In both groups the volume of contrast material was 100 mL and the injection rate was 4 mL/s. Fifty-two patients had 122 hypervascular HCCs. The diagnosis of HCCs was established histopathologically (n=24) and by imaging findings (n=98). Three readers independently analyzed four image sets: an arterial phase (AP), a portal phase (PP), an equilibrium phase (EP), and combined all three phase images set. Sensitivity, specificity, and diagnostic accuracy were calculated by receiver operating characteristic (ROC) analysis.

Results: The mean sensitivity for detecting hypervascular HCCs of the AP set, EP set, and combination set in group B (0.94, 0.81, and 0.93) was significantly higher than in group A (0.84, 0.69, and 0.80). Area under the ROC curve of the AP set and the combination set in group B (0.974 and 0.981) was significantly higher than in group A (0.939 and 0.958).

Conclusion: At the same contrast material volume and injection rate, higher iodine concentration of contrast material was effective for detecting hypervascular HCCs by MDCT.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Aged
  • Aged, 80 and over
  • Carcinoma, Hepatocellular / complications
  • Carcinoma, Hepatocellular / diagnostic imaging*
  • Contrast Media / administration & dosage
  • Dose-Response Relationship, Drug
  • Female
  • Fibrosis / complications
  • Fibrosis / diagnostic imaging*
  • Humans
  • Iodine / administration & dosage*
  • Liver Neoplasms / complications
  • Liver Neoplasms / diagnostic imaging*
  • Male
  • Middle Aged
  • Neovascularization, Pathologic / complications
  • Neovascularization, Pathologic / diagnostic imaging*
  • Reproducibility of Results
  • Sensitivity and Specificity
  • Tomography, X-Ray Computed / methods*

Substances

  • Contrast Media
  • Iodine