Abstract
Purpose
This study was aimed to compare the accuracy, sensitivity, and positive predictive value of C-arm CT (CACT) during selective transcatheter angiography with those of multidetector CT (MDCT) in the detection of hepatocellular carcinoma (HCC).
Material and methods
In this prospective study, 30 patients (mean age, 73 years) with unresectable HCC were examined with CACT before chemoembolisation. Images of a combination of CACT during arterial portography (CACTAP) and dual-phase CACT during hepatic arteriography (CACTHA) was obtained and images of intravenous contrast-enhanced, biphasic, dynamic, MDCT was also obtained beforehand. Three blinded observers independently reviewed CACT and MDCT. Diagnostic accuracy was evaluated by the alternative free-response receiver operating characteristic (AFROC) method. Sensitivities and positive predictive values (PPV) were analyzed with the paired t-test.
Results
In the mean area under the AFROC curve (Az), there was no significant difference between MDCT and CACT (MDCT, mean Az value, 0.83; CACT, 0.85, respectively) (P = 0.32). There was also no significant difference between the two techniques in sensitivity (MDCT, mean 0.65; CACT, 0.60) and PPV (MDCT, mean 0.98; CACT, 0.97) (P = 0.40, P = 0.68, respectively).
Conclusion
The diagnostic accuracy of CACT was equivalent to that of biphasic CT in the diagnosis of HCC.
Key Points
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C-arm CT helps detection of hepatocellular carcinoma (HCC) during interventional (TACE) treatment.
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C-arm CT for HCC seemed just as accurate as biphasic CT.
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TACE can be performed with greater confidence using C-arm CT.
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This study was sponsored in part by Philips Medical Systems.
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Higashihara, H., Osuga, K., Onishi, H. et al. Diagnostic accuracy of C-arm CT during selective transcatheter angiography for hepatocellular carcinoma: comparison with intravenous contrast-enhanced, biphasic, dynamic MDCT. Eur Radiol 22, 872–879 (2012). https://doi.org/10.1007/s00330-011-2324-y
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DOI: https://doi.org/10.1007/s00330-011-2324-y