Detection of Hypovascular Hepatic Metastases at Triple-Phase Helical CT: Sensitivity of Phases and Comparison with Surgical and Histopathologic Findings

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Abstract
PURPOSE: To compare the respective sensitivities of unenhanced, arterial-dominant, and portal-dominant phase helical computed tomography (CT) in the preoperative depiction of hypovascular hepatic metastases by using intraoperative ultrasonographic (US) and histopathologic findings as the standard of reference. MATERIALS AND METHODS: In this prospective study, 32 patients with 59 surgically and histopathologically proved hypovascular hepatic metastases underwent triple-phase helical CT of the liver, which included unenhanced, arterial-dominant, and portal-dominant phase scanning. Images from each phase were separately analyzed by three readers, and disagreements were resolved with consensus readings. The findings on CT images were compared with intraoperative US and histopathologic findings on a lesion-by-lesion basis to determine the sensitivity of each imaging phase. Statistical review of the lesion-by-lesion analysis was performed by using the Wilcoxon rank sum test. RESULTS: Among 59 hepatic metastases...