Skip to main content

Advertisement

SpringerLink
Log in

Diagnostic accuracy of C-arm CT during selective transcatheter angiography for hepatocellular carcinoma: comparison with intravenous contrast-enhanced, biphasic, dynamic MDCT

  • Interventional
  • Published:
European Radiology Aims and scope Submit manuscript

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

  • C-arm CT helps detection of hepatocellular carcinoma (HCC) during interventional (TACE) treatment.

  • C-arm CT for HCC seemed just as accurate as biphasic CT.

  • TACE can be performed with greater confidence using C-arm CT.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Bosch FX, Ribes J, Diaz M et al (2004) Primary liver cancer: worldwide incidence and trends. Gastroenterology 127:S5–S16

    Article  PubMed  Google Scholar 

  2. Adachi E, Maeda T, Matsumata T et al (1995) Risk factors for intrahepatic recurrence in human small Hepatocellular carcinoma. Gastroenterology 108:768–775

    Article  PubMed  CAS  Google Scholar 

  3. Ko S, Nakajima Y, Kanehiro H et al (1996) Significant influence of accompanying chronic hepatitis status on recurrence of hepatocellular carcinoma after hepatectomy. Result of multivariate analysis. Ann Surg 224:591–595

    Article  PubMed  CAS  Google Scholar 

  4. Nakamura H, Hashimoto T, Oi H, Sawada S (1989) Transcatheter oily chemoembolisation of hepatocellular carcinoma. Radiology 170:783–786

    PubMed  CAS  Google Scholar 

  5. Kanematsu M, Hoshi H, Imaeda T et al (1997) Detection and characterization of hepatic tumours: Value of combined helical CT hepatic arteriography and CT during arterial portography. AJR Am J Roentgenol 168:1193–1198

    PubMed  CAS  Google Scholar 

  6. Murakami T, Oi H, Hori M et al (1997) Helical CT during arterial portography and hepatic arteriography for detecting hypervascular hepatocellular carcinoma. AJR Am J Roentgenol 169:131–135

    PubMed  CAS  Google Scholar 

  7. Irie T, Takeshita K, Wada Y et al (1995) CT evaluation of hepatic tumours: Comparison of CT with arterial portography, CT with infusion hepatic arteriography, and simultaneous use of both techniques. AJR Am J Roentgenol 164:1407–1412

    PubMed  CAS  Google Scholar 

  8. Binkert CA, Alencar H, Singh J et al (2006) Translumbar type II endoleak repair using angiographic CT. J Vasc Interv Radiol 17:1349–1353

    Article  PubMed  Google Scholar 

  9. Hirota S, Nakao N, Yamamoto S et al (2006) C-arm CT with flat-panel-detector digital angiography system: early experience in abdominal interventional procedures. Cardiovasc Intervent Radiol 29:1034–1038

    Article  PubMed  Google Scholar 

  10. Kakeda S, Korogi Y, Hatakeyama Y et al (2008) The usefulness of three-dimensional angiography with a flat panel detector of direct conversion type in a transcatheter arterial chemoembolisation procedure for hepatocellular carcinoma: initial experience. Cardiovasc Intervent Radiol 31:281–288

    Article  PubMed  Google Scholar 

  11. Iwazawa J, Ohue S, Mitani T et al (2009) Identifying feeding arteries during TACE of hepatic tumours: comparison of C-arm CT and digital subtraction angiography. AJR Am J Roentgenol 192:1057–1063

    Article  PubMed  Google Scholar 

  12. Meyer BC, Witschel M, Frericks BB et al (2009) The value of combined soft-tissue and vessel visualisation before transarterial chemoembolisation of the liver using C-arm computed tomography. Eur Radiol 19:2302–2309

    Article  PubMed  CAS  Google Scholar 

  13. Meyer BC, Frericks BB, Voges M et al (2008) Visualization of hypervascular liver lesions During TACE: comparison of angiographic C-arm CT and MDCT. AJR Am J Roentgenol 190:W263–W269

    Article  PubMed  Google Scholar 

  14. Iwazawa J, Ohue S, Hashimoto N et al (2010) Detection of hepatocellular carcinoma: comparison of angiographic C-arm CT and MDCT. AJR Am J Roentgenol 195:882–887

    Article  PubMed  Google Scholar 

  15. Miyayama S, Yamashiro M, Okuda M et al (2011) Detection of corona enhancement of hypervascular hepatocellular carcinoma by C-arm dual-phase cone-beam CT during hepatic arteriography. Cardiovasc Intervent Radiol 34:81–86

    Article  PubMed  Google Scholar 

  16. Bruix J, Sherman M (2005) Practice Guidelines Committee, American Association for the Study of Liver Diseases: management of hepatocellular carcinoma. Hepatology 42:1208–1236

    Article  PubMed  Google Scholar 

  17. Inoue E, Fujita M, Hosomi N et al (1998) Double phase CT arteriography of the whole liver in the evaluation of hepatic tumors. J Comput Assist Tomogr 22:64–68

    Article  PubMed  CAS  Google Scholar 

  18. Hori M, Murakami T, Kim T et al (2002) Diagnosis of hepatic neoplasms using CT arterial portography and CT hepatic arteriography. Tech Vasc Interv Radiol 5:164–169

    Article  PubMed  Google Scholar 

  19. Chakraborty DP, Winter LH (1990) Free-response methodology: alternate analysis and a new observer-performance experiment. Radiology 174:873–881

    PubMed  CAS  Google Scholar 

  20. Fleiss JL (1981) The measurement of interrater agreement. In: Statistical methods for rates and proportions, 2nd edn. Wiley, New York, pp 212–236

    Google Scholar 

  21. Ishijima H, Koyama Y, Aoki J et al (1999) Use of a combined CT-angiography system for demonstration of correlative anatomy during embolotherapy for hepatocellular carcinoma. J Vasc Interv Radiol 10:811–815

    Article  PubMed  CAS  Google Scholar 

  22. Tsurusaki M, Sugimoto K, Fujii M et al (2007) Combination of CT during arterial portography and double-phase CT hepatic arteriography with multi-detector row helical CT for evaluation of hypervascular hepatocellular carcinoma. Clin Radiol 62:1189–1197

    Article  PubMed  CAS  Google Scholar 

Download references

Acknowledgements

This study was sponsored in part by Philips Medical Systems.

Author information

Authors and Affiliations

  1. Department of Diagnostic and Interventional Radiology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan

    Hiroki Higashihara, Keigo Osuga, Hiromitsu Onishi, Atsushi Nakamoto, Takahiro Tsuboyama, Noboru Maeda, Masatoshi Hori, Tonsok Kim & Noriyuki Tomiyama

Authors
  1. Hiroki Higashihara
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Keigo Osuga
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Hiromitsu Onishi
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Atsushi Nakamoto
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Takahiro Tsuboyama
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Noboru Maeda
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Masatoshi Hori
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Tonsok Kim
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Noriyuki Tomiyama
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Hiroki Higashihara.

Rights and permissions

Reprints and permissions

About this article

Cite this article

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

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00330-011-2324-y

Keyword

Search

Navigation