Yaqoob J, Bari V, Usman M U, Munir K, Mosharaf F, Akhtar W.
The Evaluation of Hepatocellular Carcinoma with Biphasic Contrast enhanced Helical CT Scan.
J Pak Med Assoc Jan ;54(3):123-7.

Objective: To evaluate the role of biphasic contrast-enhanced helical CT including Hepatic Arterial Phase (HAP) imaging with Portal Venous Phase (PVP) imaging, in the detection and characterization of hepatocellular carcinomas. Methods: The study included 40 patients (M=26, F=14) with histopathologically proven HCC. Age range was between 30-85 years (mean=55) by following consecutive patients with cirrhosis in whom Hepatocellular carcinoma was diagnosed or suspected either by raised serum a (alpha)-fetoprotein level or Ultrasound. Results: Biphasic contrast-enhanced examination revealed a total of 85 lesions in these 40 patients, out of which 13 were unifocal, 12 showed a dominant mass with satellite lesions, 2 showed cluster of contiguous nodules and 13 were multifocal HCCs. Mean diameter was 3.1 cm, ranging from 0.8 to 14 cm. On HAP imaging 85% were detected. (hyperattenuating = 69, hypoattenuating = 3) while on PVP imaging detectibility was only 48% (hyperattenuating=2, hypoattenuating=39). Hence detectibility was significantly (p=0.008) superior in HAP as compared to PVP imaging. In 7 patients (17%) tumor was visible only on HAP images. Venous invasion was present in 12 patients (30%) while arterio-portal shunting was seen in 5 patients (13%). Conclusion: Biphasic contrast enhanced helical CT is a useful method in detection and characterization of HCC (JPMA 54:123;2004).

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