HEPATOCELLULAR-CARCINOMA IN PATIENTS WHO UNDERGO LIVER-TRANSPLANTATION - SENSITIVITY OF CT WITH IODIZED OIL

PURPOSE: To evaluate the diagnostic efficacy of computed tomography (C T) after hepatic intraarterial injection of iodized oil in patients wi th hepatocellular carcinoma (HCC). MATERIALS AND METHODS: Forty patien ts who underwent CT with iodized oil before orthotopic liver transplan tation (OLT) were evaluated prospectively. All patients underwent digi tal subtraction angiography and injection of iodized oil during chemoe mbolization. CT during arterial portography (CTAP) was performed in 34 patients. The number of neoplastic nodules was assessed in explanted livers and compared with the radiologic results. RESULTS: Sixty-six HC C nodules were present in the explanted livers. CT with iodized oil en abled correct diagnosis in 38 of 66 lesions (58%), and the results wer e false-positive in two lesions (3%). Digital subtraction angiography had a sensitivity of 67% (44 of 66 nodules) and CTAP had a sensitivity of 85% (45 of 53 nodules). Four (6%) false-positive diagnoses were ma de at digital subtraction angiography and three (6%) at CTAP. The diag nostic efficacy of CT with iodized oil was significantly related to le sion diameter greater than 2 cm (P < .0001) and hypervascularity (P < .0001). CONCLUSION: CT with iodized oil failed to provide any substant ial information in the pre-OLT staging of HCC: It was inaccurate for s mall HCC nodules (<2 cm) and intrahepatic metastases. Its sensitivity matched that of digital subtraction angiography and was statistically significantly inferior to that of CTAP.