Multi–Detector Row Helical CT in Preoperative Assessment of Small (≤1.5 cm) Liver Metastases: Is Thinner Collimation Better?

TLDR

The study aimed to assess whether collimations under 5 mm improve detection of hepatic metastases ≤1.5 cm on multi‑detector row helical CT. Thirty‑one patients underwent contrast‑enhanced MDCT with reconstructions at 5.00, 3.75, and 2.50 mm collimations (50 % overlap), and three radiologists independently evaluated each lesion for type and conspicuity, using pathology and follow‑up as reference standards. While overall sensitivity rose from 66 % to 82 % with thinner collimation (p = .01), sensitivity for metastatic lesions remained 80 % across all collimations and conspicuity did not differ, indicating that sub‑5 mm collimation does not enhance detection of small hepatic metastases.

Abstract

To determine the value of collimations less than 5 mm in detecting hepatic metastases 1.5 cm or smaller by using multi-detector row helical computed tomography (CT).Thirty-one patients underwent contrast material-enhanced multi-detector row helical CT before hepatic resection in this prospective study. Images were reconstructed at collimations of 5.00, 3.75, and 2.50 mm with 50% overlap and reviewed independently by three radiologists. Each lesion was characterized as metastatic, benign, or equivocal and graded for conspicuity. Criterion standards were pathologic assessment of the resected liver and follow-up of the nonresected liver. Only lesions 1.5 cm or smaller were analyzed.There were a total of 88 liver lesions 1.5 cm or smaller, and 25 of these were metastases. Pooled sensitivity for all lesions improved with thinner collimation (66% [58 of 88 lesions], 69% [61 of 88], and 82% [72 of 88] at collimations of 5.00, 3.75, and 2.50 mm, respectively), and this was statistically significant (P =.01). However, no significant difference was noted between collimations in the pooled sensitivity for metastatic lesions (80% [20 of 25 lesions] at all collimations) (P >.99). No statistical difference was noted in the conspicuity of lesions at different collimations (P =.18).Image reconstruction with multi-detector row helical CT at collimations less than 5 mm may not improve sensitivity in the detection of hepatic metastases 1.5 cm or smaller.