Role of dual energy spectral computed tomography in characterization of hepatocellular carcinoma: Initial experience from a tertiary liver care institute
| Autor: | Archana Rastogi, Chagan Bihari, Ajeet Singh Bhadoria, G.K. Chibber, Shalini Thapar Laroia, Shiv Kumar Sarin, Yamini Venigalla |
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| Rok vydání: | 2016 |
| Předmět: |
lcsh:Medical physics. Medical radiology. Nuclear medicine
medicine.medical_specialty Spectral computed tomography Hepatocellular carcinoma lcsh:R895-920 Material density images Computed tomography HCC - Hepatocellular carcinoma Chronic liver disease Article 030218 nuclear medicine & medical imaging 03 medical and health sciences 0302 clinical medicine Iodine quantification Dual energy computed tomography medicine Radiology Nuclear Medicine and imaging In patient medicine.diagnostic_test Dual energy business.industry Dual-Energy Computed Tomography medicine.disease digestive system diseases 030220 oncology & carcinogenesis Radiology Functional imaging DECT - dual energy computed tomography business Nuclear medicine |
| Zdroj: | European Journal of Radiology Open, Vol 3, Iss, Pp 162-171 (2016) |
| ISSN: | 2352-0477 |
| Popis: | Objective: To investigate dual-energy spectral CT in characterization of hepatocellular Carcinoma (HCC) in patients with chronic liver disease. Methods: Dynamic computed tomography (CT) was performed in 3600 patients (2879 males; 721 females, mean age 50.9 ± 11.9 years) with working clinical diagnosis of liver cirrhosis for hepatocellular carcinoma screening and other clinical indications. The study was conducted over a period of 3 years. During dynamic CT scanning, spectral (monochromatic) and routine (polychromatic) CT acquisitions were obtained on a single tube, dual energy, 64 slice multi-detector CT scanner. Imaging findings were studied on routine CT. On the basis of routine CT findings, indeterminate lesions (lesions not showing characteristic hypervascularity followed by washout on dynamic routine CT scan) that were referred for biopsy or surgery were segregated. A retrospective blinded review of the lesions, acquired by the spectral CT acquisitions was done with the help of gem stone imaging (GSI) software to characterize these lesions. All the above lesions were analyzed qualitatively in the arterial phase for lesion conspicuity as well as quantitatively using the monochromatic data sets and nodule Iodine concentration on material density maps, respectively. This data was studied with respect to predictability of HCC using the spectral CT technique. Iodine density of the lesion, surrounding liver parenchyma, and lesion to liver parenchyma ratio (LLR) were derived and statistically analyzed. Histopathology of the lesion in question was treated as gold standard for analysis. Results: It was observed via statistical analysis that the value of iodine density of the lesion on material density sets of ≥29.5 mg/dl, enabled a discriminatory power of 86.5%, sensitivity of 90.5% with 95% confidence Interval (CI) (69.2–98.8%) and specificity of 81.2% with 95% Confidence Interval (54.4–95.9%) in predicting HCC. Qualitative assessment also showed higher lesion conspicuity with spectral CT image sets as compared to routine CT data. Conclusion: This study reveals that spectral imaging is an excellent qualitative as well as a quantitative tool for assessing and predicting hepatocellular carcinoma in cirrhotic patients. Keywords: Hepatocellular carcinoma, Dual energy computed tomography, Material density images, Spectral computed tomography, Functional imaging, Iodine quantification |
| Databáze: | OpenAIRE |
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