Department of Diagnostic and Interventional Radiology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita.
Department of Radiology, Osaka Medical College, 2-7 Daigakucho, Takatsuki, Osaka, Japan.
Medicine (Baltimore). 2021 Mar 26;100(12):e24902. doi: 10.1097/MD.0000000000024902.
To evaluate the diagnostic value of dual-phase cone beam CT during hepatic arteriography (CBCTHA) for hepatocellular carcinoma (HCC).Thirty seven patients with unresectable HCC underwent the dual-phase CBCTHA prior to transarterial chemoembolization (TACE). Three blinded observers independently reviewed and compared the first phase CBCTHA images alone and the dual phase CBCTHA images. Diagnostic accuracy was evaluated by the alternative free-response receiver operating characteristic method (Area under the curve: Az value). Sensitivities were analyzed with the paired t test. The analysis was performed for overall HCCs, HCCs up to 1 cm and those larger than 1 cm.For all HCCs and HCCs up to 1 cm, Az value and sensitivity showed no significant difference between the first-phase CBCTHA alone and the dual-phase CBCTHA (Az: 0.81 vs 0.88, P = .07, 0.79 and 0.85, P = .14, sensitivity: 0.61 and 0.73, P = .11, 0.41 and 0.52, P = .33, respectively). For HCCs larger than 1 cm, the mean Az value and sensitivity for the dual-phase CBCTHA were significantly higher than those for the first phase CBCTHA alone (Az: 0.96 vs 0.92, P = .008, sensitivity: 0.85 vs 0.75, P = .013, respectively).The diagnostic accuracy of the dual-phase CBCTHA was superior to that of the first phase CBCTHA alone in the diagnosis of HCC larger than 1 cm.
评估肝动脉造影（CBCTHA）中双相锥形束 CT 对肝细胞癌（HCC）的诊断价值。37 例不可切除 HCC 患者在经动脉化疗栓塞（TACE）前行双相 CBCTHA。三名盲法观察者独立评估并比较了单独的第一相 CBCTHA 图像和双相 CBCTHA 图像。采用替代自由反应接受者操作特征法（曲线下面积：Az 值）评估诊断准确性。采用配对 t 检验分析敏感性。对所有 HCC、1cm 以下 HCC 和 1cm 以上 HCC 进行分析。对于所有 HCC 和 1cm 以下 HCC，单独第一相 CBCTHA 和双相 CBCTHA 的 Az 值和敏感性无显著差异（Az：0.81 对 0.88，P=0.07，0.79 对 0.85，P=0.14，敏感性：0.61 对 0.73，P=0.11，0.41 对 0.52，P=0.33）。对于 1cm 以上 HCC，双相 CBCTHA 的平均 Az 值和敏感性明显高于单独第一相 CBCTHA（Az：0.96 对 0.92，P=0.008，敏感性：0.85 对 0.75，P=0.013）。在诊断 1cm 以上 HCC 方面，双相 CBCTHA 的诊断准确性优于单独第一相 CBCTHA。
