Detection of small hypervascular hepatocellular carcinomas by EASL criteria: comparison with double-phase CT during hepatic arteriography.

Background And Aims: To compare the detectability of small hypervascular hepatocellular carcinoma (HCC) between double-phase CT during hepatic arteriography (CTHA) criteria (hypervascular on the early-phase of CTHA and corona enhancement on the late-phase of CTHA) widely introduced in Japan and EASL criteria (hypervascular on the arterial dominant phase and wash out on the equilibrium phase of dynamic CT and/or MRI).

Methods: 116 hypervascular HCC lesions (≤2 cm) of 38 patients were evaluated. CTHA was performed in every patient, both dynamic CT and dynamic MRI in 22 patients, only dynamic CT in 8, and only dynamic MRI in 8. Among them, the detectability of HCC lesions was statistically analyzed with χ2 test.

Results: Double-phase CTHA detected all HCCs. Dynamic CT revealed 38 (40%) of 95 small HCCs; during dynamic MRI 38 (40%) of 95 small HCCs were detected. The difference between dynamic CT or dynamic MRI and CTHA was statistically significant (p<0.05).

Conclusion: The detectability of small hypervascular HCC on dynamic CT and dynamic MRI was almost the same and significantly lower as compared to that of CTHA. When comparing differences in the results of HCC treatment, differences in the diagnostic criteria applied should always be kept in mind.