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Growth Rate of Primary Single Hepatocellular Carcinoma: Determining Optimal Screening Interval with Contrast Enhanced Computed Tomography

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Abstract

To determine the optimal screening interval for detecting small (<20 mm) hepatocellular carcinoma (HCC) in a high-risk group using multiphase contrast-enhanced computed tomography (CECT), we evaluated the growth rate of primary single HCC. Forty-nine primary single HCC cases were reviewed. CECT screening was performed more than two times preceding to the diagnosis in 29 cases, and HCC nodule was identified at least two times in 22 cases. The initial nodule sizes ranged between 3 and 30 mm. Doubling time of tumor volume ranged from 34.8 to 496.4 days, with a geometric mean of 93.5 days, and a 95% lower threshold value of 27.1 days. It means that HCC will not double in diameter within 3 months. Therefore CECT screening at intervals of 3 months will detect new nodules at 10–20 mm in size and CECT screening at intervals of longer than 3 months will detect new nodules but they might be larger than 20 mm in size.

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References

  1. El-Serag HB, Mason AC: Rising incidence of hepatocellular carcinoma in the United States. N Engl J Med 340:745-750, 1999

    Google Scholar 

  2. Ince N, Wands JR: The increasing incidence of hepatocellular carcinoma. N Engl J Med 340:798-799, 1999

    Google Scholar 

  3. Figueras J, Jaurrieta E, Valls C, Ramos E, Serrano T, Rafecas A, Fabregat J, Torras J: Resection or transplantation for hepatocellular carcinoma in cirrhotic patients: outcomes based on indicated treatment strategy. J Am Coll Surg 190:580-587, 2000

    Google Scholar 

  4. Nakashima O, Sugihara S, Kage M, Kojiro M: Pathomorphologic characteristics of small hepatocellular carcinoma: a special reference to small hepatocellular carcinoma with indistinct margins. Hepatology 22:101-105, 1995

    Google Scholar 

  5. Sheu JC, Sung JL, Chen DS, Yu JY, Wang TH, Su CT, Tsang YM: Ultrasonography of small hepatic tumors using high resolution linear-array real-time instruments. Radiology 150:797-802, 1984

    Google Scholar 

  6. Chen DS, Sheu JC, Sung JL, Lai MY, Lee CS, Su CT, Tsang YM, How SW, Wang TH, Yu JY, Yang TH, Wang CY, Hsu CY: Small hepatocellular carcinoma: a clinicopathological study in thirteen patients. Gastoroenterology 813:1109-1119, 1982

    Google Scholar 

  7. Ramsey WH, WN Gy: Hepatocellular carcinoma: update on diagnosis and treatment. Dig Dis 13:81-91, 1995

    Google Scholar 

  8. Chalasani N, Said A, Ness R, Hoen H, Lumeng L: Screening for hepatocellular carcinoma in patients with cirrhosis in the United States: results of a national survey. Am J Gastroenterol 94:2224-2229, 1999

    Google Scholar 

  9. Itai Y, Matsui O: Blood flow and liver imaging. Radiology 202:306-314, 1997

    Google Scholar 

  10. Ohashi I, Hanafusa K, Yoshida T: Small hepatocellular carcinomas: two-phase dynamic incremental CT in detection and evaluation. Radiology 189:851-855, 1993

    Google Scholar 

  11. Baron RL, Oliver JH 3rd, Dodd GD 3rd, Nalesnik M, Holbert BL, Carr B: Hepatocellular carcinoma: evaluation with biphasic, contrast-enhanced, helical CT. Radiology 199:505-511, 1996

    Google Scholar 

  12. Chezmar JL, Bernardino ME, Kaufman SH, Nelson RC: Combined CT arterial portography and CT hepatic angiography for evaluation of the hepatic resection candidate. Radiology 189:407-410, 1993

    Google Scholar 

  13. Bluemke DA, Fishman EK: Spiral CT arterial portography of the liver. Radiology 186:576-579, 1993

    Google Scholar 

  14. Irie T, Takeshita K, Wada Y, Kusano S, Terahata S, Tamai S, Hatsuse K, Aoki H, Sugiura Y: CT evaluation of hepatic tumors: Comparison of CT with arterial portography, CT with infusion hepatic arteriography, and simultaneous use of both techniques. AJR 164:1407-1412, 1995

    Google Scholar 

  15. Takayasu K, Moriyama N, Muramatsu Y, Makuuchi M, Hasegawa H, Okazaki N, Hirohashi S: The diagnosis of small hepatocellular carcinomas: efficacy of various imaging procedures in 100 patients. AJR 155:49-54, 1990

    Google Scholar 

  16. Ishiguchi T, Shimamoto K, Fukatsu H, Yamakawa K, Ishigaki T:. Radiologic diagnosis of hepatocellular carcinoma. Semin Surg Oncol 12:164-169, 1996

    Google Scholar 

  17. Matsui O, Ueda K, Kobayashi S, Sanada J, Terayama N, Gabata T, Minami M, Kawamori Y, Nakanuma Y: Intra-and perinodular hemodynamics of hepatocellular carcinoma: CT observation during intra-arterial contrast infection. Abdom Imaging 27:147-156, 2002

    Google Scholar 

  18. Kanematsu M, Oliver JH 3rd, Carr B, Baron RL: Hepatocellular carcinoma: the role of helical biphasic contrast enhanced CT versus CT during arterial portography. Radiology 205:75-80, 1997

    Google Scholar 

  19. Sheu JC, Sung JL, Chen DS, Yang PM, Lai MY, Lee CS, Hsu HC, Chuang CN, Yang PC, Wang TH, Lin JT, Lee CZ: Growth rate of asymptomatic hepatocellular carcinoma and its clinical implications. Gastroenterology 89:259-266, 1985

    Google Scholar 

  20. Okazaki N, Yoshino M, Yoshida T, Suzuki N, Moriyama N, Takayasu K, Makuuchi M, Yamazaki S, Hasegawa H, Noguchi M, Hirohashi S: Evaluation of the prognosis for small hepatocellular carcinoma based on tumor volume doubling time. Cancer 63:2207-2210, 1989

    Google Scholar 

  21. Barbara L, Benzi G, Gaiani S, Fusconi F, Zironi G, Siringo S, Rigamonti A, Barbara C, Grigioni W, Mazziotti A, Bolondi L: Natural history of small untreated hepatocellular carcinoma in cirrhosis: a multivariate analysis of prognostic factors of tumor growth rate and patient survival. Hepatology 16:132-137, 1992

    Google Scholar 

  22. Ebara M, Hatano R, Fukuda H, Yoshikawa M, Sugiura N, Saisho H: Natural course of small hepatocellular carcinoma with underlying cirrhosis. A study of 30 patients. Hepatogastroenterology 3:1214-1220, 1998

    Google Scholar 

  23. Collins VP, Loeffler RK, Tivey H: Observations on growth rates of human tumors. Am J Roentgenol 76:988-1000, 1956

    Google Scholar 

  24. Schwartz M: A biomethematical approach to clinical tumor growth. Cancer 14:1272-1294, 1961

    Google Scholar 

  25. Shackney SE, McCormack GW: Growth rate patterns of solid tumors and their relation to responsiveness to therapy. Ann Intern Med 89:107-121, 1978

    Google Scholar 

  26. Lopez HE, Vogl TJ, Bechstein WO, Guckelberger O, Neuhaus P, Lobeck H, Felix R: Biphasic spiral computed tomography for detection of hepatocellular carcinoma before resection or orthotopic liver transplantation. Invest Radiol 33:216-221, 1998

    Google Scholar 

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Authors
  1. Kazunori Kubota
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  2. Hiroyasu Ina
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  3. Yoichi Okada
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  4. Tetsuya Irie
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Kubota, K., Ina, H., Okada, Y. et al. Growth Rate of Primary Single Hepatocellular Carcinoma: Determining Optimal Screening Interval with Contrast Enhanced Computed Tomography. Dig Dis Sci 48, 581–586 (2003). https://doi.org/10.1023/A:1022505203786

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