Dual-energy CT to detect recurrent HCC after TACE: Initial experience of color-coded iodine CT imaging

• DOI: 10.1016/j.ejrad.2012.11.014
• Publication Date: 2012-12-11T07:16:32Z
• Authors: Jeong-Ah Lee; Woo Kyoung Jeong; Yongsoo Kim; Soon-Young Song; Jinoo Kim; Jeong Nam Heo; Choong Ki Park
• Keywords: Aged, 80 and over; Male; Carcinoma, Hepatocellular; Iohexol; Liver Neoplasms; Contrast Media; Middle Aged; 03 medical and health sciences; 0302 clinical medicine; ROC Curve; Image Interpretation, Computer-Assisted; Feasibility Studies; Humans; Female; Chemoembolization, Therapeutic; Neoplasm Recurrence, Local; Tomography, X-Ray Computed; Aged; Retrospective Studies

To evaluate the feasibility of diagnosing recurrence of HCC after TACE color-coded iodine CT (CICT) based on arterial phase scans obtained by a dual-energy CT (DECT) scanner.A CICT scan was acquired from an iodine map after applying material decomposition of the liver tissue and setting a threshold attenuation level for viable tumors. Two radiologists reviewed both conventional and CICT sets in 31 patients who had a history of TACE for HCC. The performances in detecting local tumor progression (LTP) were evaluated by alternative free-response receiver operating characteristics. The rate of uncertain diagnosis and interobserver agreement of the diagnosis were explored. Additionally, the reading time and radiation dose were also investigated.The mean figures of merit of the conventional and CICT sets for LTP were 0.818 and 0.847, respectively (p=0.459). The rate of uncertain diagnosis was significantly decreased in CICT sets (34.5% vs. 0%), and interobserver agreement was improved (k=0.527 vs. 0.718). On the CICT set, mean reading time was reduced by 49s and mean radiation dose was also decreased by 18.3% when replacing the non-contrast CT with CICT.CICT is comparable to conventional liver CT protocol in demonstrating viable HCCs, while it allows a reduction in radiation dose.