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CT prediction of histological grade of hypervascular hepatocellular carcinoma: utility of the portal phase

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Abstract

Purpose

To elucidate whether the attenuation of hypervascular hepatocellular carcinoma (HCC) on the portal phase of dynamic CT is correlated with histological grade.

Materials and methods

This study group consisted of 66 patients with 74 surgically resected, hypervascular HCCs. On a preoperative dynamic study with a 64-multidetector row CT, the portal phase was scanned 60 s after injecting the contrast agent following the pre-contrast image and hepatic arterial phase. The tumor attenuation of each HCC on the portal phase was categorized into high, iso-, or low, and was compared with the predominant histological grade using Mann–Whitney’s U test.

Results

Twenty-nine, 29, and 16 HCCs showed high, iso-, and low attenuation on the portal phase, respectively. Tumors were classified into three well- (w-), 58 moderately (m-), or 13 poorly (p-) differentiated HCCs. The tumor attenuation of p-HCC on the portal phase was significantly lower than those of w-HCC and m-HCC (p < 0.05 and p < 0.00001).

Conclusion

The tumor attenuation on the portal phase may help when diagnosing the histological grade of hypervascular HCC. p-HCC are considered to show a faster contrast washout than w-HCC and m-HCC.

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Acknowledgments

We thank Dr. Yoshihiko Maehara, Department of Surgery and Science, Kyushu University, for providing the clinical information for this manuscript. We also thank Drs. Shin-ichi Aishima and Yoshinao Oda, Department of Anatomic Pathology, Kyushu University, for providing the pathological information for this manuscript.

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Authors and Affiliations

  1. Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan

    Akihiro Nishie, Kengo Yoshimitsu, Daisuke Okamoto, Tsuyoshi Tajima, Yoshiki Asayama, Kousei Ishigami, Daisuke Kakihara, Tomohiro Nakayama, Yukihisa Takayama & Hiroshi Honda

  2. Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan

    Ken Shirabe

  3. Department of Anatomic Pathology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan

    Nobuhiro Fujita

Authors
  1. Akihiro Nishie
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  2. Kengo Yoshimitsu
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  3. Daisuke Okamoto
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  4. Tsuyoshi Tajima
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  5. Yoshiki Asayama
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  6. Kousei Ishigami
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  7. Daisuke Kakihara
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  8. Tomohiro Nakayama
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  9. Yukihisa Takayama
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  10. Ken Shirabe
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  11. Nobuhiro Fujita
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  12. Hiroshi Honda
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Corresponding author

Correspondence to Akihiro Nishie.

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Nishie, A., Yoshimitsu, K., Okamoto, D. et al. CT prediction of histological grade of hypervascular hepatocellular carcinoma: utility of the portal phase. Jpn J Radiol 31, 89–98 (2013). https://doi.org/10.1007/s11604-012-0149-5

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  • DOI: https://doi.org/10.1007/s11604-012-0149-5

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