scholarly journals Quantitative Analysis of Hypervascular Hepatic Metastases and Hepatocellular Carcinoma using Spectral CT Imaging

2020 ◽  
Author(s):  
Zhiqiang Yang ◽  
Xinyi Wang ◽  
Hao Shi
Keyword(s):  
Hepatocellular Carcinoma ◽  
Quantitative Analysis ◽  
Spectral Curve ◽  
Iodine Concentration ◽  
Ct Imaging ◽  
Arterial Phase ◽  
Spectral Ct ◽  
Portal Venous Phase ◽  
Significant Difference ◽  
Venous Phase

Abstract Background The goal of this study is to evaluate the performance of spectral CT-based quantitative analysis in differential diagnosis of hypervascular hepatic metastasis (HVHM) and hepatocellular carcinoma (HCC). Methods Spectral CT scans were performed for 47 patients with hepatic malignant tumors, including 20 patients with HVHM and 27 patients with HCC, which generated the following sets of data: single energy images in the arterial phase; iodine and water maps; marginal areas of lesions that manifested apparent signal intensification; and energy spectral parameters of normal liver tissues and abdominal aorta. Subsequently, we calculated the normalized iodine concentrations (NIC), lesion-normal parenchyma iodine concentration ratio (LNR), iodine concentration difference (ICD) between the arterial phase and the venous phase, and the spectral curve slope. An independent samples t test and receiver operating characteristic (ROC) curve analysis were applied to examine these quantitative parameters. Results In the arterial phase, the HVHM and HCC groups displayed no differences in NIC, LNR, or spectral curve slope ( P > 0.05). In the venous phase, the two groups displayed significant differences in NIC, LNR, and spectral curve slope; the NIC was 0.59 ± 0.08 for the HVHM group and 0.4 5 ± 0.10 for the HCC group; the LNR was 1.17 ± 0.22 and 0.92 ± 0.16, respectively; the spectral curve slope was 1.85 ± 0.49 and 1.18 ± 0.34, respectively. In addition, there was no significant difference in ICD between the HVHM group (0.54 ± 0.39 g/L) and HCC group (0.45 ± 0.39 g/L) ( P > 0.05). Finally, there were no significant differences of water or iodine concentration between the arterial phase and venous phase ( P > 0.05). Taken together, the spectral curve slope in the portal venous phase had the best performance in differentiating HVHM from HCC. Conclusions HVHM and HCC have apparent differences in spectral curve and concentrations of radiocontrast agents in the portal venous phase. Hence, spectral CT imaging provides a new multiparameter quantitative approach for differentiating HVHM and HCC.

scholarly journals Quantitative Analysis of Hypervascular Hepatic Metastases and Hepatocellular Carcinoma using Spectral CT Imaging

2019 ◽  
Author(s):  
Zhiqiang Yang ◽  
Xinyi Wang ◽  
Hao Shi
Keyword(s):  
Hepatocellular Carcinoma ◽  
Quantitative Analysis ◽  
Spectral Curve ◽  
Iodine Concentration ◽  
Ct Imaging ◽  
Arterial Phase ◽  
Spectral Ct ◽  
Portal Venous Phase ◽  
Significant Difference ◽  
Venous Phase

Abstract Objective The goal of this study is to evaluate the performance of spectral CT-based quantitative analysis in differential diagnosis of hypervascular hepatic metastasis (HVHM) and hepatocellular carcinoma (HCC). Methods Spectral CT scans were performed for 47 patients with hepatic malignant tumors, including 20 patients with HVHM and 27 patients with HCC, which generated the following sets of data: single energy images in the arterial phase; iodine and water maps; marginal areas of lesions that manifested apparent signal intensification; and energy spectral parameters of normal liver tissues and abdominal aorta. Subsequently, we calculated the normalized iodine concentrations (NIC), lesion-normal parenchyma iodine concentration ratio (LNR), iodine concentration difference (ICD) between the arterial phase and the venous phase, and the spectral curve slope. An independent samples t test and receiver operating characteristic (ROC) curve analysis were applied to examine these quantitative parameters. Results In the arterial phase, the HVHM and HCC groups displayed no differences in NIC, LNR, or spectral curve slope (P > 0.05). In the venous phase, the two groups displayed significant differences in NIC, LNR, and spectral curve slope; the NIC was 0.59 ± 0.08 for the HVHM group and 0.4 5 ± 0.10 for the HCC group; the LNR was 1.17 ± 0.22 and 0.92 ± 0.16, respectively; the spectral curve slope was 1.85 ± 0.49 and 1.18 ± 0.34, respectively. In addition, there was no significant difference in ICD between the HVHM group (0.54 ± 0.39 g/L) and HCC group (0.45 ± 0.39 g/L) (P > 0.05). Finally, there were no significant differences of water or iodine concentration between the arterial phase and venous phase (P > 0.05). Taken together, the spectral curve slope in the portal venous phase had the best performance in differentiating HVHM from HCC. Conclusions HVHM and HCC have apparent differences in spectral curve and concentrations of radiocontrast agents in the portal venous phase. Hence, spectral CT imaging provides a new multiparameter quantitative approach for differentiating HVHM and HCC.

scholarly journals Imaging features of hepatocellular carcinoma with bile duct tumor thrombus：a multicenter study

2020 ◽  
Author(s):  
Li-Ming Huang ◽  
Jun-Yi Wu ◽  
Yan-Nan Bai ◽  
Jia-Yi Wu ◽  
Yong-Gang Wei ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Bile Duct ◽  
Ct Scans ◽  
Arterial Phase ◽  
Imaging Features ◽  
Portal Venous Phase ◽  
Bile Duct Tumor ◽  
Hepatic Arterial Phase ◽  
Mri Scans ◽  
Venous Phase

Abstract Background: There are still difficult and challenging problems in diagnosis of hepatocellular carcinoma (HCC) with bile duct tumor thrombus (BDTT) before operation. This study aimed to analyze the imaging features of HCC with B1-B3 BDTT. Methods: The clinicopathological data and imaging findings of 30 HCC patients with B1-B3 BDTT from three high-volume institutions were retrospectively reviewed. Eighteen patients underwent computed tomography (CT) scans and twelve patients underwent magnetic resonance imaging (MRI) scans before operation, respectively. The diagnosis of HCC with BDTT was confirmed by postoperative pathologic examination.Results: According to Japanese classification, 5 patients were classified as B1 BDTT, 12 B2, 13 B3, and 82 B4, respectively. The HCC lesions were detected in all patients, and the localized bile duct dilation were detected in 28 (93.3%) patients. The BDTT was observed in all B3 patients and 3 B2 patients, but it was not observed in all B1 patients on CT or MRI. The BDTT showed relatively hypoattenuation on plain CT scans and T1W images, relatively hyperattenuation signals on T2W. The BDTT showed hyperattenuation at hepatic arterial phase with washout at portal venous phase. The localized biliary dilation showed no enhancement at hepatic arterial phase and no progressively delayed enhancement at portal venous phase, but it was more obvious at portal venous phase on CT.Conclusions: The HCC lesions and the localized bile duct dilatation on CT or MRI scans are imaging features of HCC with BDTT, which might facilitate the early diagnosis for B1-B3 BDTT.

scholarly journals Imaging Features of Hepatocellular Carcinoma with Bile Duct Tumor Thrombus: A Multicenter Study

2020 ◽  
Author(s):  
Li-Ming Huang ◽  
Jun-Yi Wu ◽  
Yan-Nan Bai ◽  
Jia-Yi Wu ◽  
Yong-Gang Wei ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Bile Duct ◽  
Tumor Thrombus ◽  
Ct Scans ◽  
Arterial Phase ◽  
Imaging Features ◽  
Portal Venous Phase ◽  
Hepatic Arterial Phase ◽  
Mri Scans ◽  
Venous Phase

Abstract Background: There are still difficult and challenging problems in diagnosis of hepatocellular carcinoma (HCC) with bile duct tumor thrombus (BDTT) before operation. This study aimed to analyze the imaging features of HCC with B1-B3 BDTT. Methods: The clinicopathological data and imaging findings of 30 HCC patients with B1-B3 BDTT from three high-volume institutions were retrospectively reviewed. Eighteen patients underwent computed tomography (CT) scans and twelve patients underwent magnetic resonance imaging (MRI) scans before operation, respectively. The diagnosis of HCC with BDTT was confirmed by postoperative pathologic examination.Results: According to Japanese classification, 5 patients were classified as B1 BDTT, 12 B2, 13 B3, and 82 B4, respectively. The HCC lesions were detected in all patients, and the localized bile duct dilation were detected in 28 (93.3%) patients. The BDTT was observed in all B3 patients and 3 B2 patients, but it was not observed in all B1 patients on CT or MRI. The BDTT showed relatively hypoattenuation on plain CT scans and T1W images, relatively hyperattenuation signals on T2W. The BDTT showed hyperattenuation at hepatic arterial phase with washout at portal venous phase. The localized biliary dilation showed no enhancement at hepatic arterial phase and no progressively delayed enhancement at portal venous phase, but it was more obvious at portal venous phase on CT.Conclusions: The HCC lesions and the localized bile duct dilatation on CT or MRI scans are imaging features of HCC with BDTT, which might facilitate the early diagnosis for B1-B3 BDTT.

scholarly journals Evaluation of spectral CT in differentiating metastatic from non-metastatic lymph nodes in non-small cell lung cancer(NSCLC)

2020 ◽  
Author(s):  
Funan Wang ◽  
Yanwei Wang ◽  
Gang Guo ◽  
Liuhong Zhu
Keyword(s):  
Lung Cancer ◽  
Lymph Nodes ◽  
Iodine Concentration ◽  
Arterial Phase ◽  
Spectral Ct ◽  
Small Cell Lung ◽  
Metastatic Lymph Nodes ◽  
Metastatic Lymph ◽  
Venous Phase ◽  
The Difference

Abstract Background Lung cancer is the main cause of tumor-correlated deaths, analysis of lymph nodes is crucial to staging of lung cancer. The purpose of the study is to explore the importance of spectral CT imaging in the difference prognostic of metastatic and non-metastatic mediastinal lymph nodes in non-small cell lung cancer. Methods A retrospective examination of 76 patients with non-small cell lung tumor who underwent spectral CT was performed. Quantifiable GSI (Gemstone spectral imaging) parameters (eg, 40 keV, iodine concentration, water concentration) were calculated in non-contrast, arterial and venous phase in 110 mediastinal lymph nodes using AW4.6 (GE HEALTHCARE, USA). Results The CT values ​​of 40 kev, λHU (The slope of Hounsfield unit curve) and IC(values of iodine concentration values), WC(values of water concentration) measured at the arterial or venous phase were not significantly different from those of metastatic growth lymph nodes (P > 0.05). The net value of Arterial phase (nIAP,net value of iodine concentration in Arterial phase) and vein phase (nIVP, net value of iodine concentration in vein phase) were calculated. The value of nIAP was the difference between IAP (iodine concentration of arterial phase) and INCP (iondine concentration of non-contrast phase), while the value of nIVP was the difference between IVP (iodine concentration of venous phase) and INCP. There stood no noteworthy difference in nIAP amid metastatic lymph nodes and non-metastatic lymph nodes (P = 0.110). There was a substantial difference in nIVP amid metastatic lymph nodes and non-metastatic lymph nodes (P = 0.001). Conclusions Compared with qualitative assessment with conventional CT imaging features, quantitative GSI parameters (nIVP) showed higher accuracy for the preoperative diagnosis of mediastal lymph nodal metastases in patients with NSCLC.

Comparison of spectral computed tomography imaging parameters between squamous cell carcinoma and adenocarcinoma at the gastroesophageal junction

2020 ◽  
pp. 1-9
Author(s):  
Yi-Chuan Ma ◽  
Shun-Hua Zhang ◽  
Zong-Yu Xie ◽  
Fei Guo ◽  
Ai-Qi Chen
Keyword(s):  
Computed Tomography ◽  
Squamous Cell Carcinoma ◽  
Roc Curve ◽  
Gastroesophageal Junction ◽  
Ct Imaging ◽  
Arterial Phase ◽  
Spectral Ct ◽  
Imaging Parameters ◽  
Spectral Computed Tomography ◽  
Venous Phase

OBJECTIVE: To compare the spectral computed tomography (CT) imaging parameters between squamous cell carcinoma (SCC) and adenocarcinoma (AC) at the gastroesophageal junction (GEJ). METHODS: A total of 80 patients were enrolled in this retrospective study. Among them, 35 were diagnosed with SCC (SCC group) and 45 were diagnosed with AC (AC group). All patients underwent an enhanced scan with spectral CT. The following CT imaging parameters were evaluated: iodine concentration (IC), water content (WC), effective atomic number (Eff-Z) and slope of the spectral HU curve (λHU) of lesions. Receiver operating characteristic (ROC) curve was used to analyze the predictive value of spectral CT imaging parameters for diagnosis of SCC and AC. RESULTS: Patients with SCC had lower IC, Eff-Z, and λHU in arterial phase and venous phase compared with AC (p< 0.05). There were no significant differences in WC between the two groups. ROC curve analyses revealed that IC, Eff-Z, and λHU in arterial phase and venous phase were predictors for diagnosis of SCC and AC (AUC > 0.5). Moreover, the IC, Eff-Z and λHU in venous phase had better differential diagnostic performances than that in arterial phase. CONCLUSIONS: Spectral CT could be useful in the differential diagnosis of SCC and AC at the GEJ. Therefore, a routine spectral CT scan is recommended for patients with carcinoma of the GEJ.

scholarly journals Hepatocellular carcinoma in a case of hepatitis C

2017 ◽  
Vol 5 (8) ◽  
pp. 3748
Author(s):  
Pokhraj P. Suthar ◽  
Gaurav R. Parmar ◽  
Chinmay Trivedi ◽  
Hemen I. Vithlani
Keyword(s):  
Hepatocellular Carcinoma ◽  
Hepatitis C ◽  
Arterial Phase ◽  
Oesophageal Varices ◽  
Abnormal Liver Function Test ◽  
Hcv Rna ◽  
Portal Venous Phase ◽  
Hepatic Arterial Phase ◽  
Liver Cancers ◽  
Venous Phase

Hepatocellular carcinoma has incidence of 90% of all liver cancers. HCC is the second most common hepatic malignancy in children after the hepatoblastomas. Patients with hepatocellular carcinoma presents with symptoms like pruritus, splenomegaly, bleeding oesophageal varices etc. Computed Tomography of the liver can look for local spread and thorax can look for metastases. Our case was a 49-year- old hepatitis C positive female came with vague right upper quadrant abdominal discomfort with weight loss of 7 lbs in last 2 months. Mild icterus was present on examination. CT scan revealed a well-defined iso-dense lesion in the segment V of right lobe of the liver, which shows enhancement in the hepatic arterial phase and rapid washout in the portal venous phase. Laboratory investigations showed abnormal liver function test. The HCV RNA levels were 1.45×105 IU/ml by real time PCR. Histopathology examination of biopsy specimen shows characteristic morphological features of steatohepatitic variant of hepatocellular carcinoma. Then the patient was referred to the higher center for the further management.

scholarly journals Discrimination of mediastinal metastatic lymph nodes in NSCLC based on radiomic features in different phases of CT imaging

2019 ◽  
Author(s):  
Xue Sha ◽  
Guan Zhong Gong ◽  
Qing Tao Qiu ◽  
Jing Hao Duan ◽  
Deng Wang Li ◽  
...  
Keyword(s):  
Lymph Nodes ◽  
Predictive Value ◽  
Characteristic Curve ◽  
Multivariate Logistic Regression Analysis ◽  
Ct Images ◽  
Ct Imaging ◽  
Arterial Phase ◽  
Metastatic Lymph Nodes ◽  
Metastatic Lymph ◽  
Venous Phase

Abstract Background: We aimed to develop radiomic models based on different phases of computed tomography (CT) imaging and to investigate the efficacy of models for diagnosing mediastinal metastatic lymph nodes (LNs) in non-small cell lung cancer (NSCLC). Methods: We selected 231 mediastinal LNs confirmed by pathology results as the subjects, which were divided into training (n=163) and validation cohorts (n=68). The regions of interest (ROIs) were delineated on CT scans in the plain phase, arterial phase and venous phase, respectively. Radiomic features were extracted from the CT images in each phase. A least absolute shrinkage and selection operator (LASSO) algorithm was used to select features, and multivariate logistic regression analysis was used to build models. We constructed six models (orders 1-6) based on the radiomic features of the single- and dual-phase CT images. The performance of the radiomic model was evaluated by the area under the receiver operating characteristic curve (AUC), sensitivity, specificity, accuracy, positive predictive value (PPV) and negative predictive value (NPV). Results: A total of 846 features were extracted from each ROI, and 10, 9, 5, 2, 2, and 9 features were chosen to develop models 1-6, respectively. All of the models showed excellent discrimination, with AUCs greater than 0.8. The plain CT radiomic model, model 1, yielded the highest AUC, specificity, accuracy and PPV, which were 0.926 and 0.925; 0.860 and 0.769; 0.871 and 0.882; and 0.906 and 0.870 in the training and validation sets, respectively. When the plain and venous phase CT radiomic features were combined with the arterial phase CT images, the sensitivity increased from 0.879 and 0.919 to 0.949 and 0979 and the NPV increased from 0.821 and 0.789 to 0.878 and 0.900 in the training group, respectively. Conclusions: All of the CT radiomic models based on different phases all showed high accuracy and precision for the diagnosis of LN metastasis (LNM) in NSCLC patients. When combined with arterial phase CT, the sensitivity and NPV of the model was be further improved.

Acute-onset abdominal pain in a woman in her 30s

Heart ◽  
2018 ◽  
Vol 105 (4) ◽  
pp. 275-322 ◽  
Author(s):  
Rory O’Donohoe ◽  
Samantha Fitzsimmons ◽  
Timothy J C Bryant
Keyword(s):  
Abdominal Pain ◽  
Hepatocellular Adenoma ◽  
Sudden Onset ◽  
Acute Onset ◽  
Arterial Phase ◽  
List Type ◽  
Portal Venous Phase ◽  
Venous Phase ◽  
Axial Ct ◽  
Multiphase Ct

Clinical introductionA woman in her 30s presented to the emergency department with sudden-onset abdominal pain with hypotension and tachycardia. She gave a history of congenital heart disease for which she had previously undergone multiple operations. On examination she demonstrated right upper quadrant tenderness. She underwent an urgent multiphase CT (figure 1A–C).Figure 1(A) Arterial phase coronal CT. (B) Arterial phase axial CT. (C) Portal venous phase axial CT.QuestionWhat is the underlying liver pathology?Hepatocellular adenomaCholangiocarcinomaHepatocellular carcinomaFocal nodular hyperplasiaHepatoblastoma

Case 5.6

2014 ◽  
pp. 253-253
Author(s):  
Christine U. Lee ◽  
James F. Glockner
Keyword(s):  
Abdominal Pain ◽  
Equilibrium Phase ◽  
Arterial Phase ◽  
Recurrent Pancreatitis ◽  
Portal Venous Phase ◽  
History Of ◽  
Venous Phase ◽  
Delayed Phase

37-year-old woman with a history of recurrent pancreatitis and abdominal pain Arterial phase (Figure 5.6.1A), portal venous phase (Figure 5.6.1B), equilibrium phase (Figure 5.6.1C), and 8-minute delayed phase (Figure 5.6.1D) postgadolinium 3D SPGR images show multiple splenic lesions that are initially hypoenhancing relative to adjacent spleen and become hyperintense on delayed images....

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