Dynamic MR imaging and early-phase helical CT for detecting small intrahepatic metastases of hepatocellular carcinoma.

Abstract

OBJECTIVE: We performed a study to evaluate the sensitivities of multislice dynamic MR imaging and early-phase helical CT as noninvasive methods for detecting small intrahepatic metastases of hepatocellular carcinomas. MATERIALS AND METHODS: Dynamic and spin-echo MR imaging and early- and delayed-phase helical CT of the liver were performed for patients with multiple hepatocellular carcinomas before transcatheter arterial chemoembolization. Forty-nine patients had 242 intrahepatic metastases less than 3 cm in diameter. Using iodized-oil CT after transcatheter arterial chemoembolization as a gold standard, the sensitivity of MR imaging for detecting intrahepatic metastases was compared with that of CT. RESULTS: Of the 242 nodules, 225 were diagnosed as hepatocellular carcinomas by iodized-oil CT. Of these, dynamic MR imaging and early-phase CT were significantly superior to those of spin-echo MR imaging (p < .0001) and delayed phase CT (p < .0001) for tumors less than 1 cm in diameter. CONCLUSION: Dynamic MR imaging and early-phase CT of the liver are the most sensitive noninvasive means of detecting small intrahepatic metastases of hepatocellular carcinoma before and after treatment.