J Korean Soc Radiol.  2012 Nov;67(5):371-380. 10.3348/jksr.2012.67.5.371.

Dual Energy Computed Tomography to Evaluate Hepatocellular Carcinoma Treated with Transcatheter Arterial Chemo-Embolization: Comparison between the Linear Blending and Nonlinear Moidal Blending Methods

• Shin SS
• Kang HK
• Kim HW
• Kim JW
• Heo SH
• Jeong YY
• Seon HJ
• Lee D

• KMID: 1819752
• DOI: http://doi.org/10.3348/jksr.2012.67.5.371

Abstract

PURPOSE
To compare the linear blending image with the nonlinear moidal blending image using dual energy CT for the evaluation of the viable portion of hepatocellular carcinoma (HCC) after transcatheter arterial chemoembolization (TACE).
MATERIALS AND METHODS
One-hundred and twenty three HCC patients incompletely treated after TACE were enrolled in this study. The dual energy mode (80 kVp and Sn140 kVp) was only applied in the late arterial phase scanning. A paired t-test was used to compare the lesion-to-liver contrast-to-noise ratio (CNR) and the image noise between the two blending images. Lesion conspicuity, image sharpness, image noise and the overall image quality between the two blending images were compared using the Wilcoxon matched-pair signed-ranks test.
RESULTS
The lesion-to-liver CNR was significantly higher on the moidal blending image (5.6 +/- 3.2) than on the linear blending image (2.7 +/- 1.6) (p < 0.001). The image noise was significantly lower on the moidal blending image (10.9 +/- 3.5) than on the linear blending image (17.5 +/- 5.5) (p < 0.001). The lesion conspicuity and overall image quality were significantly better on the moidal blending image for both reviewers (p < 0.001). However, with respect to image sharpness, the linear blending image was significantly better for both reviewers (p > 0.01).
CONCLUSION
The nonlinear moidal blending image of dual energy CT showed an increased lesion-to-liver CNR, decreased noise and improved overall image quality for the evaluation of the viable portion of HCC after TACE.

MeSH Terms

Carcinoma, Hepatocellular
Humans
Liver
Noise

Figure

• 

  Fig. 1 A 59-year-old man who underwent two sessions of transcatheter arterial chemoembolization for HCC. A. The unenhanced CT image shows a sparsely iodized oil-retaining lesion at the right hepatic dome (arrows). B. The linear blending image obtained during the late arterial phase shows a questionable area of enhancement (arrows) within a sparsely iodized oil-retaining lesion at the right hepatic dome. C. The moidal blending image obtained during the late arterial phase more clearly demonstrates the hypervascular enhancing portion (arrows) within a sparsely iodized oil-retaining lesion at the right hepatic dome. D. The celiac axis angiogram reveals hypervascular staining (arrows) fed by branches of the right hepatic artery at the right hepatic dome. Note.-HCC = hepatocellular carcinoma

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