Diagnostic accuracy of C-arm CT during selective transcatheter angiography for hepatocellular carcinoma: comparison with intravenous contrast-enhanced, biphasic, dynamic MDCT
Diagnostic accuracy of C-arm CT during selective transcatheter angiography for hepatocellular carcinoma: comparison with intravenous contrast-enhanced, biphasic, dynamic MDCT
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DOI：
10.1007/s00330-011-2324-y
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发表时间：
2012-04-01
影响因子：
5.9
通讯作者：
Tomiyama, Noriyuki
中科院分区：
文献类型：
--
作者：
Higashihara, Hiroki;Osuga, Keigo;Tomiyama, Noriyuki
本研究旨在比较C臂CT（CACT）和多层螺旋CT（MDCT）在肝细胞癌（HCC）诊断中的准确性、敏感性和阳性预测值。获得了动脉门静脉造影（CACTAP）期间CACT和肝动脉造影（CACTHA）期间双期CACT的组合图像，并预先获得了静脉内对比剂增强、双相、动态、MDCT图像。三名设盲观察员独立审查CACT和MDCT。诊断的准确性进行了评估的替代自由反应受试者工作特征（AFROC）方法。在AFROC曲线下面积（Az）方面，MDCT和CACT的平均Az值分别为0.83和0.85，差异无统计学意义（P = 0.32）。两种技术在敏感性上也没有显著差异（MDCT，平均值0.65; CACT，0.60）和PPV MDCT平均值0.98; CACT，0.97）（P = 0.40，P = 0.68，CACT对肝癌的诊断准确性与双期CT相当，C臂CT有助于肝癌的检出C型臂CT对HCC的诊断与双相CT一样准确，使用C型臂CT进行TACE具有更高的可信度。
This study was aimed to compare the accuracy, sensitivity, and positive predictive value of C-arm CT (CACT) during selective transcatheter angiography with those of multidetector CT (MDCT) in the detection of hepatocellular carcinoma (HCC).In this prospective study, 30 patients (mean age, 73 years) with unresectable HCC were examined with CACT before chemoembolisation. Images of a combination of CACT during arterial portography (CACTAP) and dual-phase CACT during hepatic arteriography (CACTHA) was obtained and images of intravenous contrast-enhanced, biphasic, dynamic, MDCT was also obtained beforehand. Three blinded observers independently reviewed CACT and MDCT. Diagnostic accuracy was evaluated by the alternative free-response receiver operating characteristic (AFROC) method. Sensitivities and positive predictive values (PPV) were analyzed with the paired t-test.In the mean area under the AFROC curve (Az), there was no significant difference between MDCT and CACT (MDCT, mean Az value, 0.83; CACT, 0.85, respectively) (P = 0.32). There was also no significant difference between the two techniques in sensitivity (MDCT, mean 0.65; CACT, 0.60) and PPV (MDCT, mean 0.98; CACT, 0.97) (P = 0.40, P = 0.68, respectively).The diagnostic accuracy of CACT was equivalent to that of biphasic CT in the diagnosis of HCC.C-arm CT helps detection of hepatocellular carcinoma (HCC) during interventional (TACE) treatment.C-arm CT for HCC seemed just as accurate as biphasic CT.TACE can be performed with greater confidence using C-arm CT.