Dual-energy-CT of hypervascular liver lesions in patients with HCC: investigation of image quality and sensitivity

To investigate dual-energy CT of hypervascular liver lesions in patients with HCC. Forty patients with hepatocellular carcinomas were investigated with abdominal dual-energy CT. In each patient unenhanced and contrast-enhanced imaging with arterial und portovenous delay were performed. Hypervascular lesions were documented on arterial phase 80-kVp images, 140-kVp images, and the averaged arterial images by two radiologists. Subjective image quality (5-point scale, from 5 [excellent] to 1 [not interpretable]) was rated on all images. The mean number of hypervascular HCC lesions detected was 3.37 +/- 1.28 on 80-kVp images (p < 0.05), 1.43 +/- 1.13 on 140-kVp images (p < 0.05), and 2.57 +/- 1.2 on averaged images. The image quality was 0.3 +/- 0.5 for 80-kVp (p < 0.05), 1.6 +/- 0.5 for 140-kVp (p < 0.05) and 3.2 +/- 0.4 for the averaged images. Low-kVp images of dual-energy datasets are more sensitive in detecting hypervascular liver lesions. However, this increase in sensitivity goes along with a decrease in the subjective image quality of low-kVp images.