CT perfusion in hepatocellular carcinoma: Is it reliable?

Abstract

© 2017 Background: Ninety percent of hepatic cancers are hepatocellular carcinomas (HCC) which have an unfavorable prognosis. HCC is a hypervascular tumor supplied mainly by the hepatic artery. It has a higher blood supply than the surrounding hepatic tissue due to neovascularization. Computed tomography with perfusion imaging (CTP) is a non invasive tool which quantifies the blood flow parameters of HCC and compares it to the surrounding tissue. Purpose: To prove that CTP is a valuable diagnostic tool in diagnosis of HCC and posttherapeutic assessment. Patients and methods: One hundred and twenty-six HCC patients with 150 focal lesions are enrolled this study. Perfusion parameters are quantified and results are compared to those of triphasic CT. Results: CTP detected 141 lesions with 94% sensitivity and 40% specificity with elevated arterial perfusion (AP) and perfusion index (PI) with low portal flow (PF). It missed 5 lesions because of their hypovascularity and 4 lesions following radiofrequency ablation (RFA) and trans arterial chemo embolization (TACE). Conclusion: CTP is a safe and specific imaging tool for diagnosis and assessment of therapeutic interventional procedures in HCC.