Use of delayed imaging in computed tomographic arterial portography to increase accuracy in imaging hepatic tumors: A radiologic/pathologic correlation Journal Article


Authors: Brody, L. A.; Covey, A. E.; Getrajdman, G.; Sofocleous, C.; Tuorto, S.; Jarnagin, W. R.; Fong, Y.; Brown, K. T.
Article Title: Use of delayed imaging in computed tomographic arterial portography to increase accuracy in imaging hepatic tumors: A radiologic/pathologic correlation
Abstract: Background: Computed tomographic arterial portography (CTAP) has been an invaluable tool in detecting hepatic tumors for staging patients with hepatic malignancies. This technique is more sensitive than conventional computed tomography (CT) and allows for accurate surgical planning. One of the major drawbacks of CTAP has been the high false-positive rate. Delayed imaging after CTAP helps identify perfusion artifacts, increasing specificity. Using pathologic analysis of the resected specimen as the gold standard, the current study compares the sensitivity and specificity of standard CTAP to those that include a delayed-phase (210 to 240 minutes) imaging. Results: In 60 patients subjected to both phases of imaging and surgical resection of their hepatic colorectal metastases, 139 tumors were found at pathology. One hundred seventy lesions were identified on standard CTAP, with 55 being false-positive. Using delayed imaging, 155 lesions were noted, with 40 being false-positive. Thus, the sensitivity of CTAP remained high with the delayed imaging (83% vs 82% in standard CTAP), whereas the accuracy increased to 74% from 68% (p 5.01). The positive predictive values were similarly increased (74% vs 68%). Conclusion: Delayed imaging can be easily performed during the observation period after CTAP. Although there is increased radiation exposure, the delayed images increase the specificity of CTAP significantly. We therefore feel that such delayed imaging should be included in the standard evaluation of the patient with hepatic tumors undergoing CTAP. © 2010 Decker Publishing.
Keywords: liver resection; arterial portography; hepatic malignancies; liver cancer staging
Journal Title: Journal of Interventional Oncology
Volume: 3
Issue: 2
ISSN: 1916-0518
Publisher: Decker Publishing  
Date Published: 2010-01-01
Start Page: 62
End Page: 67
Language: English
DOI: 10.2310/6650.2010.000002
PROVIDER: scopus
DOI/URL:
Notes: --- - "Export Date: 9 December 2011" - "Source: Scopus"
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MSK Authors
  1. Anne Covey
    165 Covey
  2. William R Jarnagin
    903 Jarnagin
  3. Yuman Fong
    775 Fong
  4. Lynn Brody
    119 Brody
  5. Karen T Brown
    178 Brown
  6. Scott J Tuorto
    24 Tuorto