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Progression to Hypervascular Hepatocellular Carcinoma: Correlation with Intranodular Blood Supply Evaluated with CT during Intraarterial Injection of Contrast Material¹

¹ From the Department of Radiology, Kanazawa University Graduate School of Medical Science, 13-1 Takaramachi, Kanazawa 920-8641, Japan (M.H., O.M., T.G.); Department of Radiology, Kouritsu Kaga Chuo Hospital, Kaga, Japan (K.U.); Department of Radiology, Kouseiren Takaoka Hospital, Takaoka, Japan (Y.K.); and Department of Radiology, Shinshu University School of Medicine, Matsumoto, Japan (M.K.). Received July 30, 2001; revision requested September 25; revision received December 19; accepted March 12, 2002. Supported in part by a grant-in-aid for cancer research (10-16) from the Ministry of Health and Welfare of Japan. Address correspondence to M.H.

PURPOSE: To analyze the correlation between intranodular blood supply of borderline lesions (ie, dysplastic nodules or hypovascular well-differentiated hepatocellular carcinoma [HCC] nodules) and their progression to hypervascular classic HCC in cirrhotic livers.

MATERIALS AND METHODS: One hundred seventy-six borderline lesions seen at computed tomography (CT) during arterial portography (CTAP) and CT during hepatic arteriography (CTHA) were evaluated in 49 patients with cirrhosis who underwent repeated CTAP and/or CTHA but no therapy. On the basis of CTAP findings, nodules were categorized as group A (showing almost the same portal venous supply as the surrounding liver), group B (showing decreased portal venous supply) or group C (showing partially absent portal venous supply); on the basis of CTHA findings, nodules were categorized as group I (showing almost the same arterial supply as the liver), group II (showing decreased arterial supply), or group III (showing partially increased arterial supply).

RESULTS: Progression to classic HCC was observed in 29.4% of group A nodules, 53.9% of group B nodules, and 87.9% of group C nodules within 1,000 days; in 58.6% of group I nodules, 12.9% of group II nodules, and 92.2% of group III nodules within 730 days; and in 0% of nodules in group A and I, 28% of nodules in group B and/or II, and 88.7% of nodules in group C and/or III within 730 days.

CONCLUSION: Evaluation of intranodular blood supply was valuable in predicting the prognosis in borderline lesions, except when only arterial blood supply was evaluated.

© RSNA, 2002

Index terms: Liver, CT, 761.12114, 761.12116 • Liver neoplasms, blood supply, 761.31, 761.323 • Liver neoplasms, diagnosis, 761.31, 761.323 • Liver, nodules, 761.3198

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