Double phase CT during hepatic arteriography for diagnosis of hepatocellular carcinoma

Rationale and objectives: The purpose of this study is to assess the diagnostic impact of double phase computed tomography during hepatic arteriography for hepatocellular carcinoma. Materials and methods: 118 hepatocellular carcinomas in 73 cirrhotic patients who underwent double phase computed tomography during hepatic arteriography were enrolled in this study. Double phase computed tomography during hepatic arteriography consisted of computed tomography images obtained at 5-10 s (first phase) and 40-50 s (second phase) after the initiation of an intraarterial administration of 40-60 ml of contrast medium through the hepatic artery. Diagnostic accuracy of the first phase computed tomography during hepatic arteriography alone and double phase computed tomography during hepatic arteriography images for hepatocellular carcinoma were separately analyzed by three blinded readers independently. Alternative-free response receiver operating characteristic curves were constructed to compare each set of computed tomography during hepatic arteriography images. Results: The detection sensitivity of the double phase CTHA for HCC (mean, 83.1%) was significantly higher than that of the first phase CTHA alone (mean, 73.4%) (P < 0.01). Moreover. the positive predictive value of the double phase CTHA (mean, 93.7%) was higher than that of the first phase CTHA alone (87.4%). The area under the AFROC curve (Az value) of the double phase CTHA (mean, 0.88) was significantly higher than that of the first phase CTHA alone (mean, 0.77) (P < 0.05). Conclusions: Double phase computed tomography during hepatic arteriography can improve the diagnostic accuracy of hepatocellular carcinoma. (c) 2004 Elsevier Ireland Ltd. All rights reserved.