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Dual Phase Helical CT Versus Portal Venous Phase CT For the Detection of Colorectal Liver Metastases: Correlation with Intra-operative Sonography, Surgical and Pathological Findings.

Scott, D.J., Guthrie, J.A., Arnold, P.M., Ward, J., Atchley, J., Wilson, D. and Robinson, P.J. (2001) Dual Phase Helical CT Versus Portal Venous Phase CT For the Detection of Colorectal Liver Metastases: Correlation with Intra-operative Sonography, Surgical and Pathological Findings. Clinical Radiology, 56 (3). pp. 235-242. ISSN 0009-9260

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Abstract

AIM: To assess whether dual phase helical computed tomography (DPCT) of the liver improves the detection of colorectal liver metastases compared with portal venous phase (PVP) imaging alone.

MATERIALS AND METHODS: DPCT was performed in 33 consecutive patients before laparotomy for resection of colorectal liver metastases. CT comprised 8-mm slice collimation with a pitch of 1 to 1.25; imaging was commenced 20-25 and 65-70 s after the start of injection of 150 ml of contrast medium at 5 ml/s to coincide with hepatic arterial phase (HAP) and PVP contrast enhancement, respectively. Four blinded observers independently reviewed the HAP, PVP and DPCT images recording the site and size of all lesions. Alternative-free response receiver operating characteristic (AFROC) methodology was used to analyse the results, which were correlated with surgery, intra-operative ultrasound and histology.

RESULTS: The mean observer sensitivities for malignant lesion detection were 75.3% for DPCT, 69.7% for PVP imaging and 66.7% for HAP imaging alone. There was a statistically significant improvement in malignant lesion detection using DPCT when compared with PVP imaging alone (p<50.05). The mean areas under the AFROC curves were 0.84 for DPCT and 0.82 for PVP(p<50.03) imaging alone.

CONCLUSION: The detection of colorectal liver metastases was marginally better with DPCT than with PVP imaging alone, but the discovery of additional lesions did not affect the management of any of the patients in this study.

Item Type: Article
Copyright, Publisher and Additional Information: Published by Elsevier in association with the Royal College of Radiologists. Copyright © 2001 The Royal College of Radiologists.
Keywords: computed tomography; contrast media; helical CT; comparative contrast media studies; liver CT; liver neoplasms.
Institution: The University of Leeds
Academic Units: The University of Leeds > Faculty of Medicine and Health (Leeds) > School of Healthcare (Leeds) > Imaging Science (Leeds)
Depositing User: Paul M Arnold
Date Deposited: 13 Oct 2006
Last Modified: 29 Sep 2010 14:14
Published Version: http://dx.doi.org/10.1053/crad.2000.0668
Status: Published
Publisher: Elsevier Health
Refereed: Yes
Identification Number: 10.1053/crad.2000.0668
URI: http://eprints.whiterose.ac.uk/id/eprint/1637

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