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Dynamic CT for Detecting Small Hepatocellular Carcinoma: Usefulness of Delayed Phase Imaging

Shuichi Monzawa1,2, Tomoaki Ichikawa3, Hiroto Nakajima3, Yuki Kitanaka3,4, Kosaku Omata5 and Tsutomu Araki3

1 Department of Radiology, Yamanashi Hospital, Kofu, Yamanashi, Japan.
2 Present address: Department of Radiology, Hyogo Medical Center for Adults, Kitaoji 13-70, Akashi, Hyogo 673-8558, Japan.
3 Department of Radiology, School of Medicine, University of Yamanashi, Chuo Yamanashi, Japan.
4 Present address: Department of Radiology, Yokohama Sakae kyosai Hospital, Kanagawa, Japan.
5 Department of Pathology, Yamanashi Hospital, Kofu Yamanashi, Japan.


Figure 1
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  		Fig. 1A —72-year-old man with well-differentiated hepatocellular carcinoma. Arterial phase image of dynamic CT shows hyperattenuating area (arrow).

 

Figure 2
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  		Fig. 1B —72-year-old man with well-differentiated hepatocellular carcinoma. On portal venous phase image, tumor is isoattenuating and not visible.

 

Figure 3
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  		Fig. 1C —72-year-old man with well-differentiated hepatocellular carcinoma. Delayed phase image shows hypoattenuating area (arrow).

 

Figure 4
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  		Fig. 2A —69-year-old woman with well-differentiated hepatocellular carcinoma. On arterial (A) and portal venous (B) phase images of dynamic CT, tumor is mostly isoattenuating and is difficult to see.

 

Figure 5
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  		Fig. 2B —69-year-old woman with well-differentiated hepatocellular carcinoma. On arterial (A) and portal venous (B) phase images of dynamic CT, tumor is mostly isoattenuating and is difficult to see.

 

Figure 6
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  		Fig. 2C —69-year-old woman with well-differentiated hepatocellular carcinoma. Delayed phase image shows hypoattenuating area (arrow).

 

Figure 7
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  		Fig. 3 —Venn diagram shows number of tumors detected on each phase of triphasic dynamic CT. Numbers in parentheses are percentages.

 

Figure 8
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  		Fig. 4 —Graph shows composite receiver operating characteristic curves for combination of all three phases (), paired arterial and delayed phases (U), and paired arterial and portal venous phases (x).

 

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