Department of Radiology, University of Yamanashi, 1110 Shimokato, Chuo, Yamanashi, Japan.
Jpn J Radiol. 2013 Aug;31(8):521-9. doi: 10.1007/s11604-013-0217-5. Epub 2013 Jun 22.
To assess the value of hepatic arterial-phase (HAP) imaging with a low tube voltage (80 kVp), using non-helical, volumetric acquisition with a 320-detector-rows area-detector CT (ADCT) scanner for evaluating hypervascular hepatocellular carcinoma (HCC) compared with routine 120-kVp HAP imaging.
This study enrolled 128 patients with 148 HCCs. Seventy-six patients with 79 HCCs underwent HAP imaging with 80 kVp obtained using a 320-detector-rows ADCT scanner. The remaining 52 patients with 69 HCCs underwent routine HAP imaging with 120 kVp obtained by 64-slice helical acquisition. Image noise and tumor to liver contrast-to-noise ratio (CNR) of the two sets of images were compared. Three radiologists evaluated both sets of images using receiver operating characteristic analyses.
Although there was a two-fold increase in the mean image noise with 80 kVp over that with 120 kVp (p < 0.001), no significant differences were observed in CNR among the two sets. The mean area under the curve (Az value) and the sensitivity for detecting HCC with 80 kVp (0.980, 78/79, respectively) were higher than that of 120 kVp (0.892, 55/69, respectively).
HAP imaging with 80 kVp obtained by an ADCT scanner significantly improves the diagnostic performance for evaluating hypervascular HCC.
使用具有 320 排探测器的容积采集的低管电压（80 kVp）行肝动脉期（HAP）成像，评估其在诊断富血供肝细胞癌（HCC）方面的价值，并与常规的 120 kVp HAP 成像进行比较。
本研究纳入了 128 例患者的 148 个 HCC。76 例患者的 79 个 HCC 行 80 kVp HAP 成像，采用 320 排探测器的 CT 扫描仪进行非螺旋容积采集。其余 52 例患者的 69 个 HCC 行常规 120 kVp HAP 成像，采用 64 排螺旋采集。比较两组图像的噪声和肿瘤与肝脏的对比噪声比（CNR）。三位放射科医生使用受试者工作特征分析评估两组图像。
虽然 80 kVp 组的平均图像噪声是 120 kVp 组的两倍（p < 0.001），但两组的 CNR 没有显著差异。80 kVp 组的曲线下面积（Az 值）和 HCC 检出的敏感度分别为 0.980（78/79）和 78/79，高于 120 kVp 组的 0.892（55/69）和 55/69。
ADCT 扫描仪的 80 kVp HAP 成像可显著提高诊断富血供 HCC 的效能。
