Dual-energy CT to detect recurrent HCC after TACE: Initial experience of color-coded iodine CT imaging

作者：Lee Jeong Ah; Jeong Woo Kyoung^*; Kim Yongsoo; Song Soon Young; Kim Jinoo; Heo Jeong Nam; Park Choong Ki

来源：European Journal of Radiology, 2013, 82(4): 569-576.

DOI：10.1016/j.ejrad.2012.11.014

• Dual-energy CT
• Iodine map
• Hepatocellular carcinoma
• Transcatheter arterial chemoembolization (TACE)
• Recurrence
• Diagnostic performance

Objectives: To evaluate the feasibility of diagnosing recurrence of HCC after TACE color-coded iodine CT (CICT) based on arterial phase scans obtained by a dual-energy CT (DECT) scanner. %26lt;br%26gt;Methods: A CICT scan was acquired from an iodine map after applying material decomposition of the liver tissue and setting a threshold attenuation level for viable tumors. Two radiologists reviewed both conventional and CICT sets in 31 patients who had a history of TACE for HCC. The performances in detecting local tumor progression (LTP) were evaluated by alternative free-response receiver operating characteristics. The rate of uncertain diagnosis and interobserver agreement of the diagnosis were explored. Additionally, the reading time and radiation dose were also investigated. %26lt;br%26gt;Results: The mean figures of merit of the conventional and CICT sets for LTP were 0.818 and 0.847, respectively (p = 0.459). The rate of uncertain diagnosis was significantly decreased in CICT sets (34.5% vs. 0%), and interobserver agreement was improved (k = 0.527 vs. 0.718). On the CICT set, mean reading time was reduced by 49 s and mean radiation dose was also decreased by 18.3% when replacing the non-contrast CT with CICT. %26lt;br%26gt;Conclusions: CICT is comparable to conventional liver CT protocol in demonstrating viable HCCs, while it allows a reduction in radiation dose.

• 出版日期2013-4