SMALL HEPATOCELLULAR-CARCINOMA - DETECTION WITH US, CT, MR-IMAGING, DSA, AND LIPIODOL-CT

Twenty-two patients with 37 small (3 cm or less) nodular lesions of he patocellular carcinoma (HCC) were examined with ultrasonography (US), CT, MR imaging, digital subtraction angiography (DSA), and CT followin g intraarterial injection of Lipiodol (Lipiodol-CT). All patients subs equently underwent surgery, and the gold standard was provided by intr aoperative US. The detection rate was 70% for US, 65% for CT, 62% for MR imaging, 73% for DSA, and 86% for Lipiodol-CT. A significant differ ence (p<0.05) was observed between the detection rate of Lipiodol-CT a nd the detection rates of all the other imaging modalities. The differ ence was even more manifest (p<0.02) when only lesions smaller than or equal to 1 cm were considered. It is concluded that Lipiodol-CT is th e single most sensitive examination to detect small nodules of HCC. It should therefore be considered a mandatory step in the preoperative e valuation of patients with HCC considered to be surgical candidates af ter noninvasive imaging studies.