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Contrast-Enhanced CT of Small Hypovascular Hepatic Tumors

Effect of Lesion Enhancement on Conspicuity in Rabbits

¹ The Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins Medical Institutions, 600 N. Wolfe St., Baltimore, MD 21287.
² Department of Surgery, The Johns Hopkins Medical Institutions, Baltimore, MD 21287.

OBJECTIVE. The purpose of this study was to evaluate the effect of lesion enhancement on the conspicuity of small hypovascular hepatic tumors in an animal model.

MATERIALS AND METHODS. Seven VX2 hepatic tumors in five rabbits were imaged. Dynamic contrast-enhanced CT was performed at a single level centered over the lesions at 5-sec intervals for 119 sec after injection of 2 ml/kg IV contrast material at 2 ml/sec. Attenuation was measured over time within regions of interest in the tumor and normal liver, aorta, inferior vena cava, and portal vein. Lesion conspicuity, defined as the difference between the attenuation of the uninvolved liver and neoplasm, was calculated.

RESULTS. The mean diameter of the tumors on CT was 10 mm (range, 6-15 mm). The tumors appeared as low-attenuation lesions with progressive enhancement during the arterial phase and early portal phase. Peak mean lesion attenuation was 60 ± 27 H (enhancement, 23 H) at 64 sec. Peak mean lesion conspicuity was 80 ± 18 H at 39 sec, occurring 10 sec before the peak mean hepatic attenuation of 135 ± 15 H (enhancement, 67 H) at 49 sec. Relative lesion conspicuity paralleled relative enhancement of the liver throughout the imaging period.

CONCLUSION. Although low-level tumor enhancement during the arterial phase and early portal phase reduced the conspicuity of small hypovascular tumors in this animal model, our results support the use of maximum liver enhancement as a marker for peak lesion conspicuity.

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