CT perfusion in hepatocellular carcinoma: Is it reliable?

Ninety percent of hepatic cancers are hepatocellular carcinomas (HCC) which have an unfavorable prognosis. HCC is a hypervascular tumor supplied mainly by the hepatic artery. It has a higher blood supply than the surrounding hepatic tissue due to neovascularization. Computed tomography with perfusio...

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Bibliographic Details
Published in:Egyptian journal of radiology and nuclear medicine 2017-12, Vol.48 (4), p.791-798
Main Authors: Hatem Shalaby, Mennatallah, Ali Shehata, Khaled A.
Format: Article
Language:English
Subjects:
HCC
perfusion CT
Perfusion parameters
RFA
TACE
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Summary:Ninety percent of hepatic cancers are hepatocellular carcinomas (HCC) which have an unfavorable prognosis. HCC is a hypervascular tumor supplied mainly by the hepatic artery. It has a higher blood supply than the surrounding hepatic tissue due to neovascularization. Computed tomography with perfusion imaging (CTP) is a non invasive tool which quantifies the blood flow parameters of HCC and compares it to the surrounding tissue. To prove that CTP is a valuable diagnostic tool in diagnosis of HCC and posttherapeutic assessment. One hundred and twenty-six HCC patients with 150 focal lesions are enrolled this study. Perfusion parameters are quantified and results are compared to those of triphasic CT. CTP detected 141 lesions with 94% sensitivity and 40% specificity with elevated arterial perfusion (AP) and perfusion index (PI) with low portal flow (PF). It missed 5 lesions because of their hypovascularity and 4 lesions following radiofrequency ablation (RFA) and trans arterial chemo embolization (TACE). CTP is a safe and specific imaging tool for diagnosis and assessment of therapeutic interventional procedures in HCC.
ISSN:0378-603X
DOI:10.1016/j.ejrnm.2017.07.013