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Revealing Hepatic Metastases from Colorectal Cancer

Value of Combined Helical CT During Arterial Portography and CT Hepatic Arteriography with a Unified CT and Angiography System

¹ Department of Diagnostic Radiology, Aichi Cancer Center, 1-1 Kanokoden Chikusa-ku, Nagoya 464-8681, Japan.
² Department of Radiology, Gifu University School of Medicine, 40 Tsukasamachi, Gifu 500-8705, Japan.
³ Department of Radiology, Kyoto First Red Cross Hospital, Kyoto 605-0981, Japan.
⁴ Department of Gastroenterological Surgery, Aichi Cancer Center, Nagoya 464-8681, Japan.
⁵ Department of Radiology, Institute of Clinical Medicine, University of Tsukuba, Tsukuba 305-8575, Japan.

OBJECTIVE. The purpose of our study was to evaluate the use of combined helical CT during arterial portography and CT hepatic arteriography in the preoperative assessment of hepatic metastases from colorectal cancer using a unified CT and angiography system.

MATERIALS AND METHODS. Fifty-four patients with hepatic metastases from colorectal cancer preoperatively underwent combined CT during arterial portography and CT hepatic arteriography using the unified CT and angiography system. Three radiologists independently and retrospectively reviewed the images of CT during arterial portography alone, CT hepatic arteriography alone, and combined CT during arterial portography and CT hepatic arteriography. Image review was conducted on a segment-by-segment basis; a total of 432 hepatic segments with (n = 103) 118 metastatic tumors ranging in size from 2 to 160 mm (mean, 25.8 mm) and without (n = 329) tumor were reviewed.

RESULTS. Relative sensitivity of combined CT during arterial portography and CT hepatic arteriography (87%) was higher than that of CT during arterial portography alone (80%, p < 0.0005) and CT hepatic arteriography alone (83%, p < 0.005). Relative specificity of CT hepatic arteriography alone (95%, p < 0.0005) and combined CT during arterial portography and CT hepatic arteriography (96%, p < 0.0001) was higher than that of CT during arterial portography alone (91%). Diagnostic accuracy, determined by a receiver operating characteristic curve analysis, was greater with combined CT during arterial portography and CT hepatic arteriography than with CT during arterial portography alone (p < 0.05) or CT hepatic arteriography alone (p < 0.01).

CONCLUSION. Using a unified CT and angiography system, we found that combined CT during arterial portography and CT hepatic arteriography significantly raised the detectability of hepatic metastases from colorectal cancer.

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