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Optimal Arterial Phase Imaging for Detection of Hypervascular Hepatocellular Carcinoma Determined by Continuous Image Capture on 16-MDCT

¹ All authors: Department of Abdominal Imaging and Interventional Radiology, Massachusetts General Hospital and Harvard Medical School, WHT 2-270, 55 Fruit St., Boston, MA 02114.

View larger version (54K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 1 —Graph shows time–attenuation curve of hepatocellular carcinoma (HCC) (green curve marked 1), aorta (pink curve marked 2), and background liver (pink curve marked 3). Inset shows drawings for ROIs (green circle labeled as 1 is ROI for tumor; pink circles labeled as 2 and 3 show aorta and liver parenchyma, respectively, in 75-year-old woman with known HCC in right hepatic lobe. As = aorta enhancement start; Ap = aorta enhancement peak; Ts = HCC enhancement start; Tp = HCC enhancement peak.

View larger version (142K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 2A —53-year-old man with hepatitis C virus cirrhosis. Contrast-enhanced MDCT images in transverse planes at level of largest hepatocellular carcinoma (HCC) (arrows) in right lobe show start of biopsy-proven HCC enhancement (17 seconds) (A), peak enhancement of HCC (26 seconds) (B), and contrast medium end time of HCC (85 seconds) (C). Also note, additional mass (asterisks) that invades portal vein and results in segmental biliary ductal dilatation (arrowheads) in left lobe. Corresponding contrast-enhanced T1-weighted MR image (D) shows right and left lobe HCCs.

View larger version (142K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 2B —53-year-old man with hepatitis C virus cirrhosis. Contrast-enhanced MDCT images in transverse planes at level of largest hepatocellular carcinoma (HCC) (arrows) in right lobe show start of biopsy-proven HCC enhancement (17 seconds) (A), peak enhancement of HCC (26 seconds) (B), and contrast medium end time of HCC (85 seconds) (C). Also note, additional mass (asterisks) that invades portal vein and results in segmental biliary ductal dilatation (arrowheads) in left lobe. Corresponding contrast-enhanced T1-weighted MR image (D) shows right and left lobe HCCs.

View larger version (142K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 2C —53-year-old man with hepatitis C virus cirrhosis. Contrast-enhanced MDCT images in transverse planes at level of largest hepatocellular carcinoma (HCC) (arrows) in right lobe show start of biopsy-proven HCC enhancement (17 seconds) (A), peak enhancement of HCC (26 seconds) (B), and contrast medium end time of HCC (85 seconds) (C). Also note, additional mass (asterisks) that invades portal vein and results in segmental biliary ductal dilatation (arrowheads) in left lobe. Corresponding contrast-enhanced T1-weighted MR image (D) shows right and left lobe HCCs.

View larger version (133K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 2D —53-year-old man with hepatitis C virus cirrhosis. Contrast-enhanced MDCT images in transverse planes at level of largest hepatocellular carcinoma (HCC) (arrows) in right lobe show start of biopsy-proven HCC enhancement (17 seconds) (A), peak enhancement of HCC (26 seconds) (B), and contrast medium end time of HCC (85 seconds) (C). Also note, additional mass (asterisks) that invades portal vein and results in segmental biliary ductal dilatation (arrowheads) in left lobe. Corresponding contrast-enhanced T1-weighted MR image (D) shows right and left lobe HCCs.

View larger version (137K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 3A —57-year-old woman without cirrhosis. Contrast-enhanced MDCT images in transverse planes at level of largest hepatocellular carcinoma (HCC) (arrows) with care taken that regions of interest did not include necrotic areas show start of HCC enhancement (14 seconds) (A), peak enhancement (26 seconds) (B), and contrast medium end time of HCC (73 seconds) (C). Corresponding contrast-enhanced T1-weighted MR image (D) shows left lobe HCC.

View larger version (144K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 3B —57-year-old woman without cirrhosis. Contrast-enhanced MDCT images in transverse planes at level of largest hepatocellular carcinoma (HCC) (arrows) with care taken that regions of interest did not include necrotic areas show start of HCC enhancement (14 seconds) (A), peak enhancement (26 seconds) (B), and contrast medium end time of HCC (73 seconds) (C). Corresponding contrast-enhanced T1-weighted MR image (D) shows left lobe HCC.

View larger version (142K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 3C —57-year-old woman without cirrhosis. Contrast-enhanced MDCT images in transverse planes at level of largest hepatocellular carcinoma (HCC) (arrows) with care taken that regions of interest did not include necrotic areas show start of HCC enhancement (14 seconds) (A), peak enhancement (26 seconds) (B), and contrast medium end time of HCC (73 seconds) (C). Corresponding contrast-enhanced T1-weighted MR image (D) shows left lobe HCC.

View larger version (113K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 3D —57-year-old woman without cirrhosis. Contrast-enhanced MDCT images in transverse planes at level of largest hepatocellular carcinoma (HCC) (arrows) with care taken that regions of interest did not include necrotic areas show start of HCC enhancement (14 seconds) (A), peak enhancement (26 seconds) (B), and contrast medium end time of HCC (73 seconds) (C). Corresponding contrast-enhanced T1-weighted MR image (D) shows left lobe HCC.

View larger version (127K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 4A —64-year-old man with liver cirrhosis. Transverse plane contrast-enhanced MDCT images from level of largest hepatocellular carcinoma (HCC) (arrows) in right lobe show start of HCC enhancement (15 seconds) (A) and peak enhancement (23.5 seconds) (B). At 68 seconds (C), multiple additional lesions are now obvious in liver, and most HCCs have washed out. Ascites (asterisks) is also noted in parahepatic region. Corresponding contrast-enhanced T1-weighted MR image (D) shows scattered HCCs.

View larger version (135K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 4B —64-year-old man with liver cirrhosis. Transverse plane contrast-enhanced MDCT images from level of largest hepatocellular carcinoma (HCC) (arrows) in right lobe show start of HCC enhancement (15 seconds) (A) and peak enhancement (23.5 seconds) (B). At 68 seconds (C), multiple additional lesions are now obvious in liver, and most HCCs have washed out. Ascites (asterisks) is also noted in parahepatic region. Corresponding contrast-enhanced T1-weighted MR image (D) shows scattered HCCs.

View larger version (133K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 4C —64-year-old man with liver cirrhosis. Transverse plane contrast-enhanced MDCT images from level of largest hepatocellular carcinoma (HCC) (arrows) in right lobe show start of HCC enhancement (15 seconds) (A) and peak enhancement (23.5 seconds) (B). At 68 seconds (C), multiple additional lesions are now obvious in liver, and most HCCs have washed out. Ascites (asterisks) is also noted in parahepatic region. Corresponding contrast-enhanced T1-weighted MR image (D) shows scattered HCCs.

View larger version (129K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 4D —64-year-old man with liver cirrhosis. Transverse plane contrast-enhanced MDCT images from level of largest hepatocellular carcinoma (HCC) (arrows) in right lobe show start of HCC enhancement (15 seconds) (A) and peak enhancement (23.5 seconds) (B). At 68 seconds (C), multiple additional lesions are now obvious in liver, and most HCCs have washed out. Ascites (asterisks) is also noted in parahepatic region. Corresponding contrast-enhanced T1-weighted MR image (D) shows scattered HCCs.

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