Diagnostic accuracy of dual-phase cone-beam computed tomography for celiac arteriography in patients with hepatocellular carcinoma: Comparison with preoperative dynamic contrast-enhanced magnetic resonance imaging

Objectives: The diagnostic accuracy of dual-phase cone-beam computed tomography (DP-CBCT) via celiac arteriography during transarterial chemoembolization (TACE) was compared with preprocedural dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) for detecting and characterizing hepatocellular carcinoma (HCC). Materials and Methods: A total of 67 patients with HCC were enrolled who underwent TACE. Patients first underwent angiography after catheter placement in the celiac trunk, followed by DP-CBCT scanning. Finally, they received TACE, during which lipiodol was administered to mark the lesion. Lipiodol computed tomography (CT) was acquired one week after TACE and served as a reference for assessing the detection of intrahepatic lesions compared with preoperative DCE-MRI and DP-CBCT. Results: Using lipiodol CT as a reference, 172 HCC tumors were detected, including 167 by DP-CBCT and 136 by DCE-MRI. DP-CBCT showed superior diagnostic performance compared with DCE-MRI, with a higher sensitivity (95.9% vs. 76.7%), specificity (60.0% vs. 20.0%), accuracy (94.9% vs. 75.1%), and comparable precision (98.8% vs. 97.1%), respectively. The average lesion diameter was 33.14 mm in the DP-CBCT portal venous phase and 31.10 mm in the DCE-MRI portal venous phase. Compared with lipiodol CT, DCE-MRI had a different Barcelona Clinic Liver Cancer stage in 20.9% of patients compared with only 1.5% for DP-CBCT. Conclusions: DP-CBCT administered during celiac arteriography contributes to the accurate diagnosis of HCC.