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Hepatocellular nodules in liver cirrhosis: state of the art CT evaluation (perfusion CT/volume helical shuttle scan/dual-energy CT, etc.)

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Abstract

The purpose of this article is to explain the role of advanced liver CT imaging, including perfusion CT, dual-energy CT, and volume helical shuttle (VHS) scanning, with regard to its clinical applications. Perfusion CT is a promising method for calculating hepatic blood flow and portal blood flow, including microcirculation, using a color-encoded display of parameters obtained from the liver time–density curve, with iodine contrast agent. Tumor angiogenesis and assessment of the response to antiangiogenesis treatment (e.g., Sorafenib) can be analyzed by perfusion CT of the liver. VHS scan has very high temporal resolution due to the reciprocating movement employed during scanning, enabling the acquisition of 24 scans of the whole liver in the arterial dominant phase during a 40-s breath hold, and a reduction in radiation dose. Dual-energy CT enables differentiation of materials and tissues based on their CT density values, using two different energy spectra. This method includes a low tube voltage CT technique that increases the contrast enhancement of vascular structures while simultaneously reducing radiation dose. Images obtained at the preferred settings of low tube voltage and high tube current, with dose reduction in the hepatic arterial phase, are useful for detecting hypervascular hepatocellular carcinoma.

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Acknowledgments

We thank Masayuki Kudo, Akihiko Nishide, Akira Hagiwara of GE Healthcare for the advice of volume helical shuttle scan and dual-energy CT, and Takahiro Tsuboyama, MD and Masatoshi Hori, MD, PhD of Department of Radiology in Osaka University School of Medicine for data sampling.

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Authors and Affiliations

  1. Department of Radiology, Kinki University School of Medicine, 377-2 Ohno-Higashi, Osaka-Sayama, Osaka, 589-8511, Japan

    Masahiro Okada & Takamichi Murakami

  2. Department of Radiology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan

    Tonsok Kim

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  1. Masahiro Okada
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  2. Tonsok Kim
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  3. Takamichi Murakami
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Correspondence to Takamichi Murakami.

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Okada, M., Kim, T. & Murakami, T. Hepatocellular nodules in liver cirrhosis: state of the art CT evaluation (perfusion CT/volume helical shuttle scan/dual-energy CT, etc.). Abdom Imaging 36, 273–281 (2011). https://doi.org/10.1007/s00261-011-9684-2

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