Value of the unenhanced phase for detection of hepatocellular carcinomas 3 cm or less when performing multiphase computed tomography in patients with cirrhosis

J Comput Assist Tomogr. 2007 Jan-Feb;31(1):86-92. doi: 10.1097/01.rct.0000233126.21303.f0.

Abstract

Objective: To determine whether unenhanced images are of added benefit to dual-phase computed tomography (CT) for detection of hepatocellular carcinomas (HCCs) 3 cm or less.

Methods: Thirty-six patients with cirrhosis underwent unenhanced, arterial and portal venous phase CT, 17 with pathologically proven HCCs 3 cm or less and 19 without HCC. Two radiologists reviewed dual-phase images with and without unenhanced images. Presence or absence of HCC in each segment (n = 324) and subjective added benefit of unenhanced images were recorded.

Results: For readers 1 and 2, unenhanced CT was subjectively helpful in 16 (5%) of 324 and 23 (7%) of 324 segments. Sensitivity and area under the receiver operating characteristic curve were identical for dual-phase versus triple-phase images for reader 1 (82.4% and 0.882) and reader 2 (100% and 0.997).

Conclusions: Addition of unenhanced to dual-phase CT does not statistically significantly increase the diagnostic accuracy or sensitivity for HCCs 3 cm or less.

MeSH terms

  • Adult
  • Aged
  • Carcinoma, Hepatocellular / complications
  • Carcinoma, Hepatocellular / diagnostic imaging*
  • Carcinoma, Hepatocellular / pathology*
  • Female
  • Humans
  • Liver Cirrhosis / complications
  • Liver Neoplasms / diagnostic imaging*
  • Liver Neoplasms / pathology*
  • Male
  • Middle Aged
  • Retrospective Studies
  • Sensitivity and Specificity
  • Tomography, X-Ray Computed* / methods