Depiction of viable tumor in hepatocellular carcinoma treated with transarterial chemoembolization: Multiphasic helical CT with review of the previous serial CT images

Mi Jang Kyung, Dongil Choi, Hyo K. Lim, Hoon Lim Jae, Yeon Lee Ji, Jae Lee Won, Hoon Kim Seung, Jin Lee Soon, Hwan Jeon Yong, Jongmee Lee, Min Ju Kim, Wook Shin Sung, Keun Park Cheol

Research output: Contribution to journalReview article

11 Citations (Scopus)

Abstract

Objective: The purpose of our study was to assess whether a review of multiphasic helical CT combined with the previous serial CT images could be helpful to depict a viable tumor in hepatocellular carcinoma treated with transarterial chemoembolization. Materials and Methods: Twenty-four consecutive patients with 35 hepatocellular carcinomas underwent transarterial chemoembolization followed by hepatic resection. First, three radiologists independently analyzed the last CT images taken before resection for the presence of viable tumor. A second analysis was then performed using the last CT combined with the previous serial CT images. The CT analyses were then compared with the pathologic results. The added value of the review of the previous serial CT images was evaluated by performing a receiver operating characteristic analysis. The sensitivity, specificity and diagnostic accuracy for the depiction of viable tumor were also assessed, and the characteristics of the false-negative lesions were pathologically evaluated. Results: The mean diagnostic accuracies (Az values) for the depiction of viable tumor with using the last CT alone and with the review of the previous serial CT images for all observers were 0.885 and 0.901, respectively, which were not significantly difference (p > 0.05). However, the additional review of the previous serial CT images allowed the observers to render a correct diagnosis for three lesions that had been incorrectly diagnosed with the review of last CT alone. The sensitivity, specificity and diagnostic accuracy of the last CT along with the review of the previous serial CT images were 78%, 97% and 84%, respectively. All of the 16 false-negative lesions diagnosed by each observer showed 90% or greater necrosis on the pathologic examination. Conclusion: For the depiction of viable tumor in hepatocellular carcinoma treated with transarterial chemoembolization, although the difference in the diagnostic accuracies was not statistically significant, a review of the multiphasic helical CT combined with the previous serial CT images could help reach a correct diagnosis for those lesions incorrectly diagnosed with the review of the last CT alone.

Original languageEnglish
Pages (from-to)153-160
Number of pages8
JournalKorean Journal of Radiology
Volume6
Issue number3
Publication statusPublished - 2005 Jul 1
Externally publishedYes

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Spiral Computed Tomography
Hepatocellular Carcinoma
Neoplasms
Sensitivity and Specificity
ROC Curve
Necrosis
Liver

Keywords

  • Liver neoplasm, CT
  • Liver, CT

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Radiological and Ultrasound Technology

Cite this

Depiction of viable tumor in hepatocellular carcinoma treated with transarterial chemoembolization : Multiphasic helical CT with review of the previous serial CT images. / Kyung, Mi Jang; Choi, Dongil; Lim, Hyo K.; Jae, Hoon Lim; Ji, Yeon Lee; Won, Jae Lee; Seung, Hoon Kim; Soon, Jin Lee; Yong, Hwan Jeon; Lee, Jongmee; Kim, Min Ju; Sung, Wook Shin; Cheol, Keun Park.

In: Korean Journal of Radiology, Vol. 6, No. 3, 01.07.2005, p. 153-160.

Research output: Contribution to journalReview article

Kyung, MJ, Choi, D, Lim, HK, Jae, HL, Ji, YL, Won, JL, Seung, HK, Soon, JL, Yong, HJ, Lee, J, Kim, MJ, Sung, WS & Cheol, KP 2005, 'Depiction of viable tumor in hepatocellular carcinoma treated with transarterial chemoembolization: Multiphasic helical CT with review of the previous serial CT images', Korean Journal of Radiology, vol. 6, no. 3, pp. 153-160.
Kyung, Mi Jang ; Choi, Dongil ; Lim, Hyo K. ; Jae, Hoon Lim ; Ji, Yeon Lee ; Won, Jae Lee ; Seung, Hoon Kim ; Soon, Jin Lee ; Yong, Hwan Jeon ; Lee, Jongmee ; Kim, Min Ju ; Sung, Wook Shin ; Cheol, Keun Park. / Depiction of viable tumor in hepatocellular carcinoma treated with transarterial chemoembolization : Multiphasic helical CT with review of the previous serial CT images. In: Korean Journal of Radiology. 2005 ; Vol. 6, No. 3. pp. 153-160.
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title = "Depiction of viable tumor in hepatocellular carcinoma treated with transarterial chemoembolization: Multiphasic helical CT with review of the previous serial CT images",
abstract = "Objective: The purpose of our study was to assess whether a review of multiphasic helical CT combined with the previous serial CT images could be helpful to depict a viable tumor in hepatocellular carcinoma treated with transarterial chemoembolization. Materials and Methods: Twenty-four consecutive patients with 35 hepatocellular carcinomas underwent transarterial chemoembolization followed by hepatic resection. First, three radiologists independently analyzed the last CT images taken before resection for the presence of viable tumor. A second analysis was then performed using the last CT combined with the previous serial CT images. The CT analyses were then compared with the pathologic results. The added value of the review of the previous serial CT images was evaluated by performing a receiver operating characteristic analysis. The sensitivity, specificity and diagnostic accuracy for the depiction of viable tumor were also assessed, and the characteristics of the false-negative lesions were pathologically evaluated. Results: The mean diagnostic accuracies (Az values) for the depiction of viable tumor with using the last CT alone and with the review of the previous serial CT images for all observers were 0.885 and 0.901, respectively, which were not significantly difference (p > 0.05). However, the additional review of the previous serial CT images allowed the observers to render a correct diagnosis for three lesions that had been incorrectly diagnosed with the review of last CT alone. The sensitivity, specificity and diagnostic accuracy of the last CT along with the review of the previous serial CT images were 78{\%}, 97{\%} and 84{\%}, respectively. All of the 16 false-negative lesions diagnosed by each observer showed 90{\%} or greater necrosis on the pathologic examination. Conclusion: For the depiction of viable tumor in hepatocellular carcinoma treated with transarterial chemoembolization, although the difference in the diagnostic accuracies was not statistically significant, a review of the multiphasic helical CT combined with the previous serial CT images could help reach a correct diagnosis for those lesions incorrectly diagnosed with the review of the last CT alone.",
keywords = "Liver neoplasm, CT, Liver, CT",
author = "Kyung, {Mi Jang} and Dongil Choi and Lim, {Hyo K.} and Jae, {Hoon Lim} and Ji, {Yeon Lee} and Won, {Jae Lee} and Seung, {Hoon Kim} and Soon, {Jin Lee} and Yong, {Hwan Jeon} and Jongmee Lee and Kim, {Min Ju} and Sung, {Wook Shin} and Cheol, {Keun Park}",
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T1 - Depiction of viable tumor in hepatocellular carcinoma treated with transarterial chemoembolization

T2 - Multiphasic helical CT with review of the previous serial CT images

AU - Kyung, Mi Jang

AU - Choi, Dongil

AU - Lim, Hyo K.

AU - Jae, Hoon Lim

AU - Ji, Yeon Lee

AU - Won, Jae Lee

AU - Seung, Hoon Kim

AU - Soon, Jin Lee

AU - Yong, Hwan Jeon

AU - Lee, Jongmee

AU - Kim, Min Ju

AU - Sung, Wook Shin

AU - Cheol, Keun Park

PY - 2005/7/1

Y1 - 2005/7/1

N2 - Objective: The purpose of our study was to assess whether a review of multiphasic helical CT combined with the previous serial CT images could be helpful to depict a viable tumor in hepatocellular carcinoma treated with transarterial chemoembolization. Materials and Methods: Twenty-four consecutive patients with 35 hepatocellular carcinomas underwent transarterial chemoembolization followed by hepatic resection. First, three radiologists independently analyzed the last CT images taken before resection for the presence of viable tumor. A second analysis was then performed using the last CT combined with the previous serial CT images. The CT analyses were then compared with the pathologic results. The added value of the review of the previous serial CT images was evaluated by performing a receiver operating characteristic analysis. The sensitivity, specificity and diagnostic accuracy for the depiction of viable tumor were also assessed, and the characteristics of the false-negative lesions were pathologically evaluated. Results: The mean diagnostic accuracies (Az values) for the depiction of viable tumor with using the last CT alone and with the review of the previous serial CT images for all observers were 0.885 and 0.901, respectively, which were not significantly difference (p > 0.05). However, the additional review of the previous serial CT images allowed the observers to render a correct diagnosis for three lesions that had been incorrectly diagnosed with the review of last CT alone. The sensitivity, specificity and diagnostic accuracy of the last CT along with the review of the previous serial CT images were 78%, 97% and 84%, respectively. All of the 16 false-negative lesions diagnosed by each observer showed 90% or greater necrosis on the pathologic examination. Conclusion: For the depiction of viable tumor in hepatocellular carcinoma treated with transarterial chemoembolization, although the difference in the diagnostic accuracies was not statistically significant, a review of the multiphasic helical CT combined with the previous serial CT images could help reach a correct diagnosis for those lesions incorrectly diagnosed with the review of the last CT alone.

AB - Objective: The purpose of our study was to assess whether a review of multiphasic helical CT combined with the previous serial CT images could be helpful to depict a viable tumor in hepatocellular carcinoma treated with transarterial chemoembolization. Materials and Methods: Twenty-four consecutive patients with 35 hepatocellular carcinomas underwent transarterial chemoembolization followed by hepatic resection. First, three radiologists independently analyzed the last CT images taken before resection for the presence of viable tumor. A second analysis was then performed using the last CT combined with the previous serial CT images. The CT analyses were then compared with the pathologic results. The added value of the review of the previous serial CT images was evaluated by performing a receiver operating characteristic analysis. The sensitivity, specificity and diagnostic accuracy for the depiction of viable tumor were also assessed, and the characteristics of the false-negative lesions were pathologically evaluated. Results: The mean diagnostic accuracies (Az values) for the depiction of viable tumor with using the last CT alone and with the review of the previous serial CT images for all observers were 0.885 and 0.901, respectively, which were not significantly difference (p > 0.05). However, the additional review of the previous serial CT images allowed the observers to render a correct diagnosis for three lesions that had been incorrectly diagnosed with the review of last CT alone. The sensitivity, specificity and diagnostic accuracy of the last CT along with the review of the previous serial CT images were 78%, 97% and 84%, respectively. All of the 16 false-negative lesions diagnosed by each observer showed 90% or greater necrosis on the pathologic examination. Conclusion: For the depiction of viable tumor in hepatocellular carcinoma treated with transarterial chemoembolization, although the difference in the diagnostic accuracies was not statistically significant, a review of the multiphasic helical CT combined with the previous serial CT images could help reach a correct diagnosis for those lesions incorrectly diagnosed with the review of the last CT alone.

KW - Liver neoplasm, CT

KW - Liver, CT

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