INTRAHEPATIC METASTATIC NODULES OF HEPATOCELLULAR-CARCINOMA DETECTED AT LIPIODOL-CT - IMAGING-PATHOLOGICAL CORRELATION

Background: The purpose of this study was to determine whether tiny (< 2 cm) areas of iodized-oil retention diagnosed as intrahepatic metasta tic nodules of hepatocellular carcinoma (HCC) at computed tomography ( CT) following intraarterial injection of Lipiodol (Lipiodol-CT) correl ate with truly cancerous foci on the corresponding sectioned pathologi c specimens. Methods: Thirty-two consecutive patients with biopsy-prov en HCC (26 men and six women, aged 41-72 years) underwent prospective evaluation with Lipiodol-CT before undergoing surgery (hepatic resecti on, 30 patients; liver transplantation, two patients). Imaging finding s were correlated with intraoperative and pathologic findings. Results : Twenty-one areas of retained Lipiodol (0.5-1.6 cm in diameter, mean +/- SD: 0.9 +/- 0.3 cm) had features consistent with intrahepatic meta static nodules of HCC on Lipiodol-CT scans. Nineteen of the 21 areas c orrelated with tumor deposits at pathologic examination of the surgica l specimens, whereas two of 21 were due to abnormal retention of iodiz ed oil within noncancerous liver parenchyma. The positive predictive v alue of findings at Lipiodol-CT for the diagnosis of intrahepatic meta static nodule of HCC was 90.5%. Conclusions: Findings at Lipiodol-CT e nable a reliable diagnosis of intrahepatic metastatic nodules of HCC.