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European Radiology

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01-06-2013 | Hepatobiliary-Pancreas

Hepatocellular carcinoma and focal nodular hyperplasia of the liver: differentiation with CT spectral imaging

Authors: Yixing Yu, Xiaozhu Lin, Kemin Chen, Weimin Chai, Shudong Hu, Rongbiao Tang, Jing Zhang, Lixiu Cao, Fuhua Yan

Published in: European Radiology | Issue 6/2013

Abstract

Objectives

To investigate the value of CT spectral imaging in differentiating hepatocellular carcinoma (HCC) from focal nodular hyperplasia (FNH) during the arterial phase (AP) and portal venous phase (PP).

Methods

Fifty-eight patients with 42 HCCs and 16 FNHs underwent spectral CT during AP and PP. The lesion–liver contrast-to-noise ratio (CNR) at different energy levels, normalised iodine concentrations (NIC) and the lesion–normal parenchyma iodine concentration ratio (LNR) were calculated. The two-sample t test compared quantitative parameters. Two readers qualitatively assessed lesion types according to imaging features. Sensitivity and specificity of the qualitative and quantitative studies were compared.

Results

In general, CNRs at low energy levels (40–70 keV) were higher than those at high energy levels (80–140 keV). NICs and LNRs for HCC differed significantly from those of FNH: mean NICs were 0.25 mg/mL ± 0.08 versus 0.42 mg/mL ± 0.12 in AP and 0.52 mg/mL ± 0.14 versus 0.86 mg/mL ± 0.18 in PP. Mean LNRs were 2.97 ± 0.50 versus 6.15 ± 0.62 in AP and 0.99 ± 0.12 versus 1.22 ± 0.26 in PP. NICs and LNRs for HCC were lower than those of FNH. LNR in AP had the highest sensitivity and specificity in differentiating HCC from FNH.

Conclusions

CT spectral imaging may help to increase detectability of lesions and accuracy of differentiating HCC from FNH.

Key Points

• CT spectral imaging may help to detect hepatocellular carcinoma (HCC).

• CT spectral imaging may help differentiate HCC from focal nodular hyperplasia.

• Quantitative analysis of iodine concentration provides greater diagnostic confidence.

• Treatment can be given with greater confidence.

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Title: Hepatocellular carcinoma and focal nodular hyperplasia of the liver: differentiation with CT spectral imaging
Authors: Yixing Yu
Xiaozhu Lin
Kemin Chen
Weimin Chai
Shudong Hu
Rongbiao Tang
Jing Zhang
Lixiu Cao
Fuhua Yan
Publication date: 01-06-2013
Publisher: Springer-Verlag
Published in: European Radiology / Issue 6/2013
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-012-2747-0

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Hepatocellular carcinoma and focal nodular hyperplasia of the liver: differentiation with CT spectral imaging

Abstract

Objectives

Methods

Results

Conclusions

Key Points

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objectives

Methods

Results

Conclusions

Key Points

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