Detection of hepatocellular carcinoma by CT during arterial portography using a cone-beam CT technology: comparison with conventional CTAP

Abstract

To evaluate the detectability of hepatocellular carcinoma (HCC) by computed tomography during arterial portography (CTAP) using cone-beam CT technology (CBCTAP) by comparing it with conventional CTAP. Forty-four HCC lesions (mean diameter 1.9 +/- 1.1 cm) of 24 patients who sequentially underwent conventional CTAP and CBCTAP during the same angiography session were evaluated. CBCTAP findings of each tumor were classed into three grades as compared to conventional CTAP: optimal; suboptimal; and nondiagnostic. All CBCTAP images had image artifacts from the catheter placed in the superior mesenteric artery and enhanced portal veins. Additionally, the contrast between HCC lesion and surrounding liver parenchyma of CBCTAP images was less than that of CTAP images. Of the 44 tumors, findings of 31 nodules (mean 2.2 +/- 1.2 cm) (70.5%) were classed as optimal. Eight nodules (mean 1.4 +/- 0.8 cm) (18.2%) were classed as suboptimal. Five nodules (mean 1.0 +/- 0.1 cm) (11.4%) including two located in the outside of field of view were classed as nondiagnostic. CBCTAP had sufficient image quality to detect almost all small HCC lesions compared to conventional CTAP and could depict approximately 89% of HCC nodules, including eight suboptimal lesions.