Multidetector Computed Tomography Perfusion as a Diagnostic Tool in Evaluation of Hepatic Focal Lesions

Purpose: To evaluate the diagnostic accuracy of Multidetector Computed Tomography Perfusion in hepatic focal lesions. Patients and Methods: Multidetector Computed Tomog-raphy Perfusion was performed in 50 patients with hepatic focal lesions. A quantitative analysis of each perfusion parameter of the hepatic focal lesions and the background liver was performed. Results: Regarding the non treated hepatocellular carcinoma patients, there is increase in blood flow and decrease in mean transit time in 100% of cases compared with the background liver, while changes of blood volume and permeability surface area product were of low validity. The treated hepatocellular carcinoma cases with transarterial chemoembolization show increase in blood flow and permeability surface area product (100%), while decrease in mean transit time (80%) of cases. Metastatic cases show increase in the blood flow and decrease in mean transit with significant p-value. The results were not specific to differentiate between hepatocellular carcinoma and metastases. All patients with benign lesions show decrease in blood volume compared with the background liver. Changes in blood flow, mean transit time and permeability surface area product of examined benign focal lesions compared with normal liver parenchyma were non significant. Conclusion: Multidetector Computed Tomography Perfusion is an emerging imaging tool which allows functional evaluation of tissue vascularity and provides both qualitative and quantitative information in hepatic focal lesions, regarding tumor angiogenesis used in diagnosis and therapeutic follow-up of hepatocellular carcinoma lesions with significant diagnostic validity.