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J Korean Radiol Soc. 2003 Dec;49(6):475-482. Korean. Original Article. https://doi.org/10.3348/jkrs.2003.49.6.475
Kim YM , Jung JW , Joh JH , Cha SH , Park KS .
Department of Radiology, Sejong General Hospital & Sejong Heart Institute. ymkim11@be.md
Department of Diagnostic Radiology, Seoul National University College of Medicine.
Department of Diagnostic Radiology, Soonchunhyang University College of Medicine.
Department of Diagnostic Radiology, Chungbuk National University College of Medicine.
Abstract

PURPOSE: To assess, by means of CT-pathologic correlation, the ability of CT to detect hepatic VX-2 carcinomas in rabbits, and to determine the factors influencing the sensitivity of tumor detection. MATERIALS AND METHODS: By means of direct portal inoculation, VX-2 carcinomas were implanted in the liver of eight rabbits after laparotomy. Two weeks later, dual-phase spiral CT scanning was performed using scan parameters of 3-mm collimation and reconstruction intervals of 1 mm and 3 mm. Radiologic-pathologic correlation involved the comparison of CT images and pathologic slices. The sensitivity and positive predictive value with which each technique detected the presence of tumors were calculated. RESULTS: Using pathologic slices, 2-40 (mean, 9.1) mm in size, 65 tumor nodules were detected. Overall sensitivity and the positive predictive value were 63% and 73%, respectively. Sensitivities for tumors of 2-5 mm and 6-10 mm were 28% and 79%, respectively. For images reconstructed with a 1-mm interval, sensitivity was significantly higher than that where a 3-mm interval was used (79% vs. 46%), but sensitivities for arterial and portal-phase imaging were not significantly different. Among small tumors (< or = 10 mm), 63% (12/19) showed strong enhancement at arterial-phase imaging. Regarding tumor detection, inter-observer concordance between the three radiologists was excellent for portal-phase images (k=0.86 and 0.83 for 1 mm and 3 mm reconstruction intervals, respectively), and good for arterial-phase images (k=0.77 and 0.73 for 1 mm and 3 mm reconstruction intervals, respectively. CONCLUSION: Even where dual-phase scanning with 3-mm collimation is used, spiral CT is limited in its ability to detect tumors 5 mm or less in diameter, though overlapping reconstruction improves the sensitivity with which those of 6-10 mm are detected. In the evaluation of arterial-phase images obtained at contrast-enhanced dual-phase imaging, special attention should be given to small hyper-attenuating nodules.

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