| Received | : | Nov 08, 2018 |
| Accepted | : | Dec 21, 2018 |
| Published Online | : | Dec 31, 2018 |
| Journal | : | Journal of Radiology and Medical Imaging |
| Publisher | : | MedDocs Publishers LLC |
| Online edition | : | http://meddocsonline.org |
Cite this article: Zafar W, Zulfiqar Z, Din N, Murad S, Iqbal B. Biphasic & triphasic computed tomography (CT) scan in focal tumoral liver lesions. J Radiol Med Imaging. 2018; 3: 1012.
Objective: To assess the diagnostic accuracy of biphasic & triphasic spiral CT in differentiating benign from malignant focal tumoral liver lesions in the patients of Gujranwala region.
Methods: The study was conducted in Department of Radiology of Medcare International Hospital and GINUM cancer hospital, Gujranwala from 11 March 2015 to December 2015.
Results: Among 60 patients, 60 liver lesions (11 benign and 49 malignant) were detected with the help of different enhancement patterns. Out of these, 49 (81.67%) patients had malignant in which 26 patients suffered from multifocal HCC, 15 patients had single focal lesion, 5 patients had secondary mets and 3 had cholangiocarcinoma. while 11 (18.33%) had benign lesions. Then I compared results of 41 patients including, suspected of or diagnosed with HCC. Who depicted elevated AFP levels and diagnosed with HCC.
Conclusion: Biphasic & triphasic CT scan is a good noninvasive tool in characterizing and differentiating benign from malignant liver lesions.
Keywords: Liver lesions; Biphasic; Triphasic-CT scan
Focal liver lesions can be defined as any lesion in the liver other than the normal parenchyma with or without causing structural and functional abnormality of hepatobiliary system and can be of variable size.
Hepatocellular carcinoma is the fourth most common hepatic disorder in Pakistan with prevalence of 8-10%. This prevalence rate is high when compared to western data.
Histopathology is the gold standard, biopsy is always not possible as it is an invasive technique. Computed Tomography (CT) is the imaging modality most often used to evaluate focal liver lesions.
The liver receives approximately 30% of its blood supply from the hepatic artery and 70% from the portal vein, most primary and secondary liver neoplasms receive 80-95% of their blood supply from the hepatic artery.
Recent studies have also reported an improvement in lesion detection if arterial phase imaging is performed in addition to portal venous imaging especially in the presence of hyper vascular neoplasms, such as hepatocellular carcinoma.
Most metastases to the liver are hypo vascular and consequently are best detected during the portal venous phase.
Histopathology is the gold standard; biopsy is always not possible as it is an invasive technique. Computed Tomography (CT) is the imaging modality most often used to evaluate focal liver lesions.
To assess the diagnostic accuracy of biphasic & triphasic spiral CT in differentiating benign from malignant focal tumoral liver lesions in the patients of Gujranwala region.
The study was conducted in Department of Radiology of Medcare International Hospital and GINUM cancer hospital, Gujranwala from 11th March 2015 to December 2015.
Among 60 patients, 60 liver lesions (11 benign and 49 malignant) were detected with the help of different enhancement patterns. Out of these, 49 (81.67%) patients had malignant in which 26 patients suffered from multifocal HCC,15 patients had single focal lesion, 5 patients had secondary mets and 3 had cholangiocarcinoma. while 11 (18.33%) had benign lesions.
Then I compared results of 41 patients including, suspected of or diagnosed with HCC. Who depicted elevated AFP levels and diagnosed with HCC. Mean elevated AFP levels in all HCC patients were, 421 +/- 59 microg/ml (range 157-4019 microg/ ml) in males and 163 +/- 32 microg/ml (range 101-2341 microg/ ml) in females6. It was also noted that 41 males and female patients, exhibited elevated levels of AFP. Then I follow these patients clinically & confirm the presence of HCC in 41 out of 60 patients.
Figure 1: Phases of triphasic ct scan.
Figure 2: Study Graph.
Figure 3: 45mm Hemangioma in segment 5 of liver.
Figure 4: Single focal lesion.
Triphasic CT scan is a good non-invasive tool and can be used as first line imaging modality for differentiating benign and malignant focal liver lesions to avoid unnecessary biopsies of benign lesions e.g. haemangioma.
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