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Re-evaluation of detectability of liver metastases by contrast-enhanced CT: added value of hepatic arterial phase imaging

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Abstract

Purpose

We compared the detectability of liver metastases on 2- and 3-phase images using robust statistical methods. Nine radiologists evaluated unenhanced CT plus portal venous phase (2-phase) images and 2-phase plus hepatic arterial phase (HAP) (3-phase) images.

Materials and methods

Our study included 54 patients with primary malignant tumors who underwent 3-phase hepatic dynamic CT more than twice to screen for liver metastases; 24 had 1–6 liver metastases measuring 4–27 mm in diameter (median 13 mm). The other 30 had no metastases. Nine board-certified radiologists participated in our observer performance study. They specified the location of the metastatic lesions and rated the probability of metastatic nodules on 2-phase images acquired with and without HAP imaging. We used jackknife alternative free-response receiver operating characteristic (JAFROC) analysis to compare their performances.

Results

For all radiologists the area under the curve without and with HAP imaging was 0.86 and 0.88, respectively; the difference was significant (p = 0.04). For metastases smaller than 10 mm the averaged lesion localization fraction without and with HAP imaging was 0.17 and 0.26 (p < 0.01).

Conclusion

Adding HAP to 2-phase imaging improved the detectability of liver metastases, especially of lesions smaller than 10 mm.

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Conflict of interest

This study was performed using a research grant provided to the Department of Diagnostic Radiology, Hiroshima University (Chair: Kazuo Awai) by Bayer Yakuhin Co. Ltd. (Osaka, Japan). The other authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Department of Diagnostic Radiology, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan

    Yukiko Honda, Toru Higaki, Haruka Higashihori, Fuminari Tatsugami, Shuji Date & Kazuo Awai

  2. Department of Diagnostic Radiology, Hiroshima Prefectural Hospital, Hiroshima, Japan

    Yoshio Monzen

Authors
  1. Yukiko Honda
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  2. Toru Higaki
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  3. Haruka Higashihori
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  4. Yoshio Monzen
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  5. Fuminari Tatsugami
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  6. Shuji Date
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  7. Kazuo Awai
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Corresponding author

Correspondence to Kazuo Awai.

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Honda, Y., Higaki, T., Higashihori, H. et al. Re-evaluation of detectability of liver metastases by contrast-enhanced CT: added value of hepatic arterial phase imaging. Jpn J Radiol 32, 467–475 (2014). https://doi.org/10.1007/s11604-014-0331-z

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  • DOI: https://doi.org/10.1007/s11604-014-0331-z

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