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Multi–Detector Row Helical CT in Preoperative Assessment of Small (1.5 cm) Liver Metastases: Is Thinner Collimation Better?¹

¹ From the Departments of Medical Imaging (M.A.H., M.M.A., D.C.R., M.E.O., A.E.H., G.A.L.) and Laboratory Medicine and Pathology (M.R.), and the University Avenue Hepatobiliary-Pancreatic Surgical Oncology Program (S.G.), Princess Margaret Hospital, University Health Network and Mount Sinai Hospital, University of Toronto, 610 University Ave, Toronto, Ontario, Canada M5G 2M9. From the 2000 RSNA scientific assembly. Received July 19, 2001; revision requested August 16; final revision received March 26, 2002; accepted April 18. Address correspondence to M.A.H. (e-mail: m.haider@utoronto.ca).

PURPOSE: To determine the value of collimations less than 5 mm in detecting hepatic metastases 1.5 cm or smaller by using multi–detector row helical computed tomography (CT).

MATERIALS AND METHODS: Thirty-one patients underwent contrast material–enhanced multi–detector row helical CT before hepatic resection in this prospective study. Images were reconstructed at collimations of 5.00, 3.75, and 2.50 mm with 50% overlap and reviewed independently by three radiologists. Each lesion was characterized as metastatic, benign, or equivocal and graded for conspicuity. Criterion standards were pathologic assessment of the resected liver and follow-up of the nonresected liver. Only lesions 1.5 cm or smaller were analyzed.

RESULTS: There were a total of 88 liver lesions 1.5 cm or smaller, and 25 of these were metastases. Pooled sensitivity for all lesions improved with thinner collimation (66% [58 of 88 lesions], 69% [61 of 88], and 82% [72 of 88] at collimations of 5.00, 3.75, and 2.50 mm, respectively), and this was statistically significant (P = .01). However, no significant difference was noted between collimations in the pooled sensitivity for metastatic lesions (80% [20 of 25 lesions] at all collimations) (P > .99). No statistical difference was noted in the conspicuity of lesions at different collimations (P = .18).

CONCLUSION: Image reconstruction with multi–detector row helical CT at collimations less than 5 mm may not improve sensitivity in the detection of hepatic metastases 1.5 cm or smaller.

© RSNA, 2002

Index terms: Computed tomography (CT), helical, 761.12115 • Liver, CT, 761.12115 • Liver, surgery, 761.1267 • Liver neoplasms, metastases, 761.3317

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