Malignant liver lesions: Comparison of spiral CT arterial portography and MR imaging for diagnostic accuracy, cost, and effect on patient management
✍ Scribed by Richard C. Semelka; James F. Schlund; Paul L. Molina; Ann Bagley Willms; Morton Kahlenberg; Matthew A. Mauro; Susan M. Weeks; William G. Cance
- Publisher
- John Wiley and Sons
- Year
- 1996
- Tongue
- English
- Weight
- 722 KB
- Volume
- 6
- Category
- Article
- ISSN
- 1053-1807
No coin nor oath required. For personal study only.
✦ Synopsis
We cornpaxed two imaging techniques, spiral CT arterial portbgraphy ( C T m and M R imaging. for diacplostie ace -, procedural cost, and effect w management of 26 patients referred for hepatic surgery for suspected limited mall$trant Uver disease. CTAP and M R imaging were done within a 1-week period (19 within 24 hours]: the results of the studies wen interpreted prospectively by separate reviewers. Surgical data were evaluated in -ction with imagiag data In 10 patients. Lesion detection and segmental involvement were determined and sensitivity and spci&ity were calculated. m ed d cost was determined h m hospital billing codes. meat on patient management w determined by the referring oncologic surgeon. CTAP and M R imaging showed 185 and 176 true-lmdtive malignant lesions, 15 true-negative maUgnaut lesions. and 13 and 22 falsenegative mdignant lesions. respectively. CTAP and M R imnging showed 1W and 105 true-positive seginenb, negative segments, and four and six fabe-negative segments, mpedvely. There was a signWcant dIffennce in sped8dty of segmental involvement between M R imaging (1.0 * 0) oomparcd with CTAP (0.88 ? 0.05). P = .03. Total procedural cost was bS.499 for CTAP and $1,224 for MR imaging. CTAP hdings did not change patient management over M R imaging hdings in any patient, whereas blR imaging hdings resulted In P change in patient management over CTAP &rd€ngs In m e n patienu (P = .016). The results of our study suggest that 1Iw imaging has higher diagnostic uxuracy and greater effect 011 patient management than CTAP does and is 6 4 % b expmeive. and z c f ~ f&e-pOSiti~e malilplant lesions, t t l ~ and 18 11 and false-positim ~e -e ~~t s . 80 and 91 true-Index terms: Liver neoplasms. metastases -Llver neoplasms. diagnosis Liver neoplasms. M R * Liver neoplasms. CT