Individualized lesion-oriented test-bolus arterial-phase CT improves lesion enhancement and conspicuity in hepatocellular carcinoma
Background - Accurate arterial-phase timing in contrast-enhanced CT (CECT) is critical for evaluating hepatocellular carcinoma (HCC). Standard-delay methods may fail to capture peak arterial enhancement due to interindividual hemodynamic variability, potentially reducing lesion conspicuity. This stu...
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| Auteurs principaux: | , , , , , , , , , , , , , |
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| Format: | Article (Journal) |
| Langue: | anglais |
| Publié: |
July 2026
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| In: |
European journal of radiology
Year: 2026, Volume: 200, Pages: 1-8 |
| ISSN: | 1872-7727 |
| DOI: | 10.1016/j.ejrad.2026.112875 |
| Accès en ligne: | Verlag, kostenfrei, Volltext: https://doi.org/10.1016/j.ejrad.2026.112875 Verlag, kostenfrei, Volltext: https://www.sciencedirect.com/science/article/pii/S0720048X26002238 
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| Notes sur l'auteur: | Christian Schmidt, Can Yüksel, Roman Iwa, Eric Corban, Emona Staudacher, Martina Distelmaier, Youssra Obeidi, Narine Mesropyan, Kunpeng Xie, Jonathan Lemessa, Florian Haag, Christiane Kuhl, Philipp Bruners, Felix Barajas Ordonez |
| Résumé: | Background - Accurate arterial-phase timing in contrast-enhanced CT (CECT) is critical for evaluating hepatocellular carcinoma (HCC). Standard-delay methods may fail to capture peak arterial enhancement due to interindividual hemodynamic variability, potentially reducing lesion conspicuity. This study evaluated whether individualized, dynamically tailored arterial-phase CT (t-CT) based on test-bolus peak in the lesion or, if not feasible, within the portal vein, improves quantitative enhancement and lesion conspicuity compared with standard-delay CT (s-CT). - Materials and methods - This intraindividual study included 39 patients with 60 HCC lesions who underwent both t-CT and s-CT. Maximum and mean lesion attenuation (HUmax, HUmean), relative lesion-to-liver attenuation (relative HUmax, relative HUmean), and image noise were measured. Four readers rated lesion conspicuity on a five-point Likert scale; inter-reader agreement was assessed using weighted κ, Krippendorff’s α, and intraclass correlation coefficient (ICC). - Results - All quantitative parameters differed significantly between protocols. HUmax was greater in t-CT than on s-CT (151.0 [130.0-199.8] HU vs 113.5 [97.0-150.0]; p < 0.001), as well as HUmean (124.5 [104.5-144.8] HU vs 90.5 [79.8-112.8]; p < 0.001), relative HUmax (1.9 [1.7-2.3] vs 1.8 [1.5-2.2]; p = 0.009) and relative HUmean (1.6 [1.4-1.9] vs 1.4 [1.3-1.7]; p < 0.001). Image noise was lower on t-CT than on s-CT (8.4 [6.7-9.7] vs 11.1 [9.6-12.9]; p < 0.001). Median lesion conspicuity was higher on t-CT (4.0 vs 3.0; p < 0.001). - Conclusion - Individualized lesion-oriented test bolus arterial-phase timing in CECT demonstrated higher lesion attenuation, greater lesion-to-liver contrast, lower image noise, and higher visibility compared with standard arterial-phase timing in HCC. |
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| Description: | Online verfügbar: 15. April 2026, Artikelversion: 19. April 2026 Gesehen am 26.05.2026 |
| Description matérielle: | Online Resource |
| ISSN: | 1872-7727 |
| DOI: | 10.1016/j.ejrad.2026.112875 |