Journal of the Korean Society of Radiology (대한영상의학회지)

The Korean Society of Radiology (대한영상의학회)
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Detection of Recurrent/Residual Hepatocellular Carcinoma: Single-Center Retrospective Comparative Study Between Parenchymal Blood Volume Mapping Using Cone Beam CT and Multiphase Dynamic CT

재발 또는 잔여 간세포암의 발견에서 콘빔 단층촬영을 이용한 실질혈류량 지도와 다중검출 전산화단층촬영의 비교: 단일 기관 후향적 연구

  • Kim, Na Rae (Department of Radiology, Eulji University Hospital, Eulji University) ;
  • Kim, Ji Dae (Department of Radiology, Anyang Sam Hospital) ;
  • Han, Hyun Young (Department of Radiology, Eulji University Hospital, Eulji University) ;
  • Kim, Hee Jin (Department of Radiology, Eulji University Hospital, Eulji University)
  • 김나래 (을지대학교 의과대학 을지대학교병원 영상의학과) ;
  • 김지대 (안양샘병원 영상의학과) ;
  • 한현영 (을지대학교 의과대학 을지대학교병원 영상의학과) ;
  • 김희진 (을지대학교 의과대학 을지대학교병원 영상의학과)
  • Received : 2018.03.06
  • Accepted : 2018.04.21
  • Published : 2018.08.01
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Abstract

Purpose: To evaluate the usefulness of cone beam computed tomography (CT)-based parenchymal blood volume (PBV) mapping for the detection of marginal recurrence or residual hepatocellular carcinoma, after transcatheter arterial chemoembolization (TACE), and to compare it with multiphase dynamic CT (MDCT). Materials and Methods: From March 2015 to October 2016, 26 patients with 49 iodized nodules who underwent TACE and a pre-interventional MDCT scan were enrolled in our study. We evaluated the diagnostic efficacies of PBV mapping using cone beam CT and MDCT in the detection of marginal recurrences or viable tumors. Results: The sensitivity, specificity, positive predictive value, and negative predictive value (NPV) of PBV mapping and MDCT were 100%, 96.7%, 94.7%, and 100%, and 77.9%, 93.5%, 87.5%, and 87.8%, respectively. The overall sensitivity for identifying local marginal recurrence was higher for PBV mapping than for MDCT (p < 0.005). The performances of PBV mapping and MDCT in the diagnosis of local marginal recurrence were significantly different (p = 0.037, McNemar test). Conclusion: Compared with MDCT, PBV mapping can significantly increase the detection of marginal recurrence or residual tumor after TACE because it is free of beam-hardening artifact. PBV mapping should be considered as a feasible modality-related tool for patients who have undergone chemoembolization.

목적: 경동맥화학색전술 후 재발 또는 잔여 간세포암 발견에 있어서, 콘빔 단층촬영을 이용한 실질혈류량 지도와 다중검출 전산화단층촬영을 비교하고 실질혈류량 지도의 유용성을 평가하고자 하였다. 대상과 방법: 2015년 5월부터 2016년 10월까지 이전에 경동맥화학색절술을 시행 받고 추적 다중검출 전산화단층촬영을 받은 26명의 환자의 총 49개의 색전된 결절을 대상으로 후향 연구를 시행하였다. 실질혈류량 지도와 다중검출 전산화단층촬영의 간세포암의 발견에 있어 진단적 정확도를 비교 분석하였다. 결과: 색전된 58개 결절에서 실질혈류량 지도의 간세포암 진단 민감도, 특이도, 양성 예측도, 음성 예측도는 각각 100%, 96.7%, 94.7%, 100%이었고 다중검출 전산화단층촬영의 민감도, 특이도, 양성 예측도, 음성 예측도는 77.9%, 93.5%, 87.5%, 87.8%였다. 콘빔 단층촬영을 이용한 실질혈류량 지도의 민감도가 의미 있게 높았으며(p < 0.005) 간세포암 발견율에 두 검사 간 유의한 차이를 보였다(p = 0.037, McNemar test). 결론 : 실질혈류량 지도의 경우 선속 경화현상이 없기 때문에 이전에 경동맥화학색전술을 시행 받은 환자에서 재발 또는 잔여 간세포암 발견에 있어서 다중검출 전산화단층촬영보다 유용할 것으로 생각된다.

Keywords

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