iothalamate-meglumine and Carcinoma--Hepatocellular

To compare the appearance of small hepatic hemangiomas at nonenhanced and contrast material-enhanced helical computed tomography (CT) with that of small (<3-cm) hypervascular malignant liver tumors and to evaluate the accuracy of multiphase helical CT for differentiating small hemangiomas from small hypervascular malignant tumors.. Radiologists reviewed multiphase helical CT liver images in 86 patients with 37 hemangiomas and 49 malignant liver tumors. They evaluated lesion type and degree of enhancement for change from arterial to portal venous phase. They rated their confidence in the discrimination of hemangiomas from malignant tumors.. At arterial phase CT, enhancement similar to aortic enhancement was observed in 19%-32% of hemangiomas and 0%-2% of malignant tumors; globular enhancement, in 62%-68% and 4%-12%, respectively. At portal venous phase CT, enhancement similar to blood pool enhancement was observed in 43%-54% of hemangiomas and 4%-14% of malignant tumors; globular enhancement, in 46%-49% and 0%-2%, respectively. For all readers and all phases of enhancement, the area under the receiver operating characteristic curves was 0.81-0.87, indicating that inherent accuracy of CT is high and that there was no significant difference (P >.28) in overall accuracy. Readers diagnosed hemangiomas with 47%-53% mean sensitivity with all enhancement phases and diagnosed malignant lesions with 95% mean specificity.. Small hemangiomas frequently show atypical appearances at CT. Two-phase helical CT does not improve sensitivity but does improve specificity for differentiating hemangiomas from hypervascular malignant tumors.

Topics: Carcinoma, Hepatocellular; Contrast Media; Diagnosis, Differential; Female; Hemangioma; Humans; Iothalamate Meglumine; Liver Neoplasms; Male; Middle Aged; Observer Variation; ROC Curve; Sensitivity and Specificity; Tomography, X-Ray Computed; Triiodobenzoic Acids

To evaluate the added value of hepatic arterial-dominant phase (HAP) imaging to portal venous-dominant phase (PVP) imaging in patients with hepatocellular carcinoma (HCC) at computed tomography (CT).. Sixty-six patients with proved HCC underwent biphasic contrast-enhanced CT. HAP and PVP images were obtained at 20-50 and 60-100 seconds, respectively. PVP images were evaluated for the number of HCC foci. Then, HAP images were reviewed to determine whether any additional HCCs were seen.. Three hundred twenty-six tumor foci were seen. HAP images depicted 309 foci (95%) and PVP images 268 (82%). In seven patients (11%), tumor was visible only on HAP images. During the HAP, tumors were hyperattenuating compared with liver in 26 patients, of mixed attenuation in 26, and hypoattenuating in 14 without correlation with histologic appearance. Portal vein thrombosis was identified in 17 of 21 patients on HAP images; in 12 patients, the thrombosis was diagnosed as malignant with neovascularity within the thrombus or diffuse thrombus enhancement.. Use of both HAP and PVP contrast-enhanced CT optimizes the evaluation of patients with or at risk for HCC.

Topics: Carcinoma, Hepatocellular; Contrast Media; Female; Humans; Image Processing, Computer-Assisted; Iothalamate Meglumine; Liver Neoplasms; Male; Middle Aged; Neoplastic Cells, Circulating; Portal Vein; Sensitivity and Specificity; Time Factors; Tomography, X-Ray Computed; Triiodobenzoic Acids

In this study we describe the investigation and treatment of 14 patients with primary hepatocellular carcinoma. Patients were treated with intra-arterial infusion of iodized oil and doxorubicin hydrochloride. Five of these patients were alive after 1 year. Twelve patients showed a fall in alpha-fetoprotein, and in seven of these patients, the fall in alpha-fetoprotein was greater than 50%.

Topics: Adult; Carcinoma, Hepatocellular; Cell Line; DNA Replication; Doxorubicin; Female; Follow-Up Studies; Humans; Infusions, Intra-Arterial; Iodized Oil; Iothalamate Meglumine; Liver Neoplasms; Male; Pilot Projects; Tomography, X-Ray Computed

Thirty-two patients with hepatocellular carcinoma less than 5 cm in diameter were examined by computed tomography. At the examination 26 patients (81%) were correctly diagnosed. A common type of CT image series was detectable as low density on the precontrast scan, a positive or mixed pattern on dynamic scan, and visible on postcontrast scan. In 10 patients with minute tumors (less than 2 cm), 7 were correctly diagnosed. CT was valuable for diagnosis of the small hepatocellular carcinomas larger than 1 cm by using the dynamic study after an intravenous bolus injection of the contrast medium.

Topics: Adult; Aged; Carcinoma, Hepatocellular; Female; Humans; Iothalamate Meglumine; Liver Neoplasms; Male; Middle Aged; Tomography, X-Ray Computed