Hepatocellular carcinoma: Iodized-oil CT TNM classification

OBJECTIVE. We conducted a prospective study to determine the efficacy of iodized-oil enhancement in CT for preoperative assessment of the T factor of the TNM classification in patients with hepatocellular carcinoma (HCC). SUBJECTS AND METHODS. Iodized-oil CT was performed as a part of preoperative staging in 28 patients with HCC. We determined the radiologic T factor, Pathologic correlation was obtained after orthotopic liver transplantation (n = 25) or autopsy (n = 3), and the histologic T factor was determined. RESULTS. The sensitivity of iodized-oil CT for accurately distinguishing between stage-T4 tumors and tumors in stages T1-T3 was 88% (7/8) with a positive predictive value of 100% (7/7). CONCLUSION. Iodized-oil CT is useful for preoperatively assessing the T factor of the TNM classification in HCC, and it improves the accuracy of radiologic staging. Iodized-oil CT can help to better select patients with HCC for orthotopic liver transplantation.