Journal of Clinical and Translational Hepatology

Journal of Clinical and Translational Hepatology

Saturday, 10 / 16 / 2021

Abstract

ORIGINAL ARTICLE

Differentiation of Hepatocellular Carcinoma from Hepatic Hemangioma and Focal Nodular Hyperplasia using Computed Tomographic Spectral Imaging

Weixia Li1,#, Ruokun Li1,#, Xiangtian Zhao2,#, Xiaozhu Lin3, Yixing Yu4, Jing Zhang1, Weimin Chai1Fuhua Yan1,*

1  Department of Radiology, Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
2  Department of Radiology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China
3  Department of Nuclear Medicine, Ruijin Hospital affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
4  Department of Radiology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
#These authors contributed equally to this work.
*Correspondence to: Fuhua Yan, Department of Radiology, Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, 197 Ruijin Erlu, Huangpu District, Shanghai 200025, China. ORCID: https://orcid.org/0000-0002-6385-499X . Tel: +86-21-6437-0045-665724, Fax: +86-21-6384-2916, E-mail:This email address is being protected from spambots. You need JavaScript enabled to view it.

Journal of Clinical and Translational Hepatology 2021;9(3):315-323 DOI: 10.14218/JCTH.2020.00173
Received: December 21, 2020 Accepted: March 7, 2021 Published online: March 31, 2021

Abstract

Background and Aims:Hepatocellular carcinoma (HCC) is the most common primary hepatic malignancy. This study was designed to investigate the value of computed tomography (CT) spectral imaging in differentiating HCC from hepatic hemangioma (HH) and focal nodular hyperplasia (FNH).

Methods: This was a retrospective study of 51 patients who underwent spectral multiple-phase CT at 40–140 keV during the arterial phase (AP) and portal venous phase (PP). Slopes of the spectral curves, iodine density, water density derived from iodine- and water-based material decomposition images, iodine uptake ratio (IUR), normalized iodine concentration, and the ratio of iodine concentration in liver lesions between AP and PP were measured or calculated.

Results:As energy level decreased, the CT values of HCC (n=31), HH (n=17), and FNH (n=7) increased in both AP and PP. There were significant differences in IUR in the AP, IUR in the PP, normalized iodine concentration in the AP, slope in the AP, and slope in the PP among HCC, HH, and FNH. The CT values in AP, IUR in the AP and PP, normalized iodine concentration in the AP, slope in the AP and PP had high sensitivity and specificity in differentiating HH and HCC from FNH. Quantitative CT spectral data had higher sensitivity and specificity than conventional qualitative CT image analysis during the combined phases.

Conclusions:Mean CT values at low energy (40–90 keV) and quantitative analysis of CT spectral data (IUR in the AP) could be helpful in the differentiation of HCC, HH, and FNH.

Keywords

Hepatocellular carcinoma, Hepatic hemangioma, Focal nodular hyperplasia, Computed tomography spectral imaging, Spectral curve

Journal of Clinical and Translational Hepatology 2021 vol. 9, 315-323  [ Html  ] [ PDF Full-text ]

© 2021 Authors. This is an Open Access article distributed under the terms of the  Creative Commons Attribution-Noncommercial 4.0 License(CC BY-NC 4.0), permitting all non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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