Ohtani Takashi, Ozaki Kumi, Ishida Tomokazu, Takahashi Kouki, Shimada Masato, Kanai Satomi, Wakabayashi Tasuku, Takata Kenji, Tateishi Toshiki, Tsujikawa Tetsuya
Radiological Center, University of Fukui Hospital, Fukui, Japan.
Department of Radiology, Faculty of Medical Sciences, University of Fukui, Fukui, Japan.
Quant Imaging Med Surg. 2025 Sep 1;15(9):8219-8229. doi: 10.21037/qims-2024-2592. Epub 2025 Aug 14.
The clinical utility of electron density (ED), obtained by non-contrast dual-energy computed tomography, has been demonstrated for the diagnosis of brain tumors and bone lesions; however, the clinical utility of ED in the liver has not been adequately reported. This study aimed to compare ED between hepatocellular carcinomas (HCCs), liver metastases, hepatic hemangiomas, and hepatic cysts and assess the differential diagnostic performance of ED between malignant tumors and benign lesions.
Eighty-nine patients (53 men and 36 women; mean age, 67.2±13.2 years) were included. EDs were measured for 24 HCCs, 19 liver metastases, 28 hepatic hemangiomas, and 18 hepatic cysts. The relative ED (rED), normalized by the ED of the background liver parenchyma, was calculated. The ED and rED of the focal hepatic lesions (FHLs) were statistically analyzed. Receiver operating characteristic curve analysis was used to evaluate the diagnostic performance of ED and rED in differentiating malignant tumors from benign lesions.
The ED and rED were higher in malignant tumors than in benign lesions. Significant differences in ED were observed among all lesions (P<0.05) except liver metastases and hepatic hemangiomas. Significant differences in rED were observed among all lesions (P<0.05) except HCCs and liver metastases. The area under the curve of rED for distinguishing between malignant tumors and benign lesions was significantly larger than that of ED (0.88 0.80, P<0.05).
ED aids in the differential diagnosis of FHLs. The use of rED further improves diagnostic performance.
通过非增强双能量计算机断层扫描获得的电子密度（ED）在脑肿瘤和骨病变的诊断中的临床效用已得到证实；然而，ED在肝脏中的临床效用尚未得到充分报道。本研究旨在比较肝细胞癌（HCC）、肝转移瘤、肝血管瘤和肝囊肿之间的ED，并评估ED在恶性肿瘤和良性病变之间的鉴别诊断性能。
纳入89例患者（53例男性和36例女性；平均年龄67.2±13.2岁）。对24例HCC、19例肝转移瘤、28例肝血管瘤和18例肝囊肿进行了ED测量。计算经背景肝实质ED标准化的相对ED（rED）。对肝脏局灶性病变（FHL）的ED和rED进行统计学分析。采用受试者操作特征曲线分析评估ED和rED在鉴别恶性肿瘤和良性病变中的诊断性能。
恶性肿瘤的ED和rED高于良性病变。除肝转移瘤和肝血管瘤外，所有病变之间的ED均存在显著差异（P<0.05）。除HCC和肝转移瘤外，所有病变之间的rED均存在显著差异（P<0.05）。用于区分恶性肿瘤和良性病变的rED曲线下面积显著大于ED（0.88对0.80，P<0.05）。
ED有助于FHL的鉴别诊断。使用rED可进一步提高诊断性能。
