Abstract
The objective of our study was to determine whether the conventionally used enhancement threshold of 10 HU for assessing tumor viability in treated hepatocellular carcinoma (HCC) lesions is valid. To distinguish pseudoenhancement from enhancement in a tumor, we used an in vivo model: The attenuation of 54 hepatic cysts during the unenhanced and portal venous phases of MDCT, similar to what may be observed in HCC with central necrosis, was used to determine the threshold for pseudoenhancement. To validate this model, we compared the attenuation value of liver parenchyma in this cohort with that of 22 HCCs during the late arterial phase of enhancement. We tested the effect of this pseudoenhancement on quantifying necrosis in HCC compared with the conventionally used threshold of 10 HU. Values of enhancing HCC tissue on arterial phase MDCT (mean, 121.3 HU) were comparable with normal liver parenchyma on venous phase MDCT (117.3 HU) (p = 0.27). The threshold of 17.1 HU was the best threshold for the detection of pseudoenhancement in cysts (99% accuracy, 100% sensitivity, and 98% specificity). When this threshold was used instead of the conventional threshold of 10 HU, the mean necrosis proportion of treated HCC increased from 34.0%...Continue Reading
References
Jan 1, 1986·Radiology·M A Bosniak
Nov 7, 1999·Radiology·D D MakiG T Herman
Feb 5, 2000·AJR. American Journal of Roentgenology·C H CoulamR C Nelson
Aug 31, 2000·Radiology·K T BaeH F Bennett
Oct 11, 2001·Journal of Hepatology·J BruixUNKNOWN EASL Panel of Experts on HCC
Feb 21, 2004·AJR. American Journal of Roentgenology·K H Y LeeA Hanbidge
Sep 6, 2005·Urology·Gary M Israel, Morton A Bosniak
Apr 13, 2006·IEEE Transactions on Medical Imaging·Jan-Martin KuhnigkHeinz-Otto Peitgen
Feb 22, 2007·AJR. American Journal of Roentgenology·Ana L KeppkeFrank H Miller
Feb 22, 2007·AJR. American Journal of Roentgenology·Frank H MillerRiad Salem
Mar 3, 2007·Radiology·Shamima SultanaYasuyuki Yamashita
May 2, 2007·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Haesun ChoiRobert S Benjamin
Aug 22, 2007·Radiology·Bernard A BirnbaumJames S Babb
Jul 18, 2008·Radiology·Zhen J WangBenjamin M Yeh
Feb 23, 2010·Seminars in Liver Disease·Riccardo Lencioni, Josep M Llovet
Jul 14, 2010·Journal of Postgraduate Medicine·S E McSweeneyK Jhaveri
Nov 4, 2010·Gastroenterology·Riad SalemMary F Mulcahy
Mar 5, 2011·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·Jordi BruixUNKNOWN American Association for the Study of Liver Diseases
May 24, 2011·Korean Journal of Radiology : Official Journal of the Korean Radiological Society·Sung Ho HwangKi Whang Kim
Dec 24, 2011·AJR. American Journal of Roentgenology·Rafel TappouniErik B Lehman
Oct 30, 2012·Clinical Imaging·Victor SaiZhen J Wang
Jan 24, 2014·AJR. American Journal of Roentgenology·Jeet PatelJoel F Platt
Citations
Nov 14, 2017·Radiographics : a Review Publication of the Radiological Society of North America, Inc·Khaled M ElsayesClaude B Sirlin
May 3, 2019·Future Oncology·Francesca PatellaBradford J Wood
Feb 26, 2019·Korean Journal of Radiology : Official Journal of the Korean Radiological Society·Sungwon KimJin Young Choi
Sep 25, 2021·Radiographics : a Review Publication of the Radiological Society of North America, Inc·Frank H MillerRobert J Lewandowski