Clinical value of spectral CT imaging combined with AFP in identifying liver cancer and hepatic focal nodular hyperplasia.
Rui Xu, Jing Wang, Xiaoyu Huang, Qiaoying Zhang, Yijing Xie, Pang Lan, Liangcai Bai, Junlin Zhou
Abstract
PURPOSE: To investigate the clinical value of spectral computed tomography (CT) imaging combined with alpha-fetoprotein (AFP) in identifying liver cancer and hepatic focal nodular hyperplasia (FNH). METHODS: A total of 132 patients with local liver space-occupying lesions, including 68 patients with liver cancer, were randomly enrolled. All the patients underwent spectral CT imaging and AFP examinations. The corresponding specificity, sensitivity, accuracy rate, positive predictive value and negative predictive value of spectral CT imaging, AFP and combined detection were recorded, respectively, with pathological findings as the gold standards. SPSS 17.0 software was used for statistical analysis. P<0.05 suggested that the difference was statistically significant. RESULTS: The diagnostic rate of spectral CT imaging was 79.5% for liver cancer and 81.3% for hepatic FNH. In arterial phase and portal venous phase, the contrast-to-noise ratio (CNR) of liver cancer was remarkably lower than that of FNH, showing a statistically significant difference, and the difference was the greatest at 70-100 keV between the two kinds of lesions. The detection rate of AFP for liver cancer was 86.8%, and the exclusive diagnostic rate of AFP for hepatic FNH was 96.9%. AFP had the highest specificity (73.2%) in identifying liver cancer and hepatic FNH. The spectral CT imaging possessed the highest sensitivity (91.7%) in identifying liver cancer and hepatic FNH. Both the sensitivity (98.1%) and accuracy (89.1%) of spectral CT imaging combined with AFP were the highest in identifying liver cancer and hepatic FNH. CONCLUSION: The spectral CT imaging combined with AFP is conducive to improving the efficiency of differential diagnosis of liver cancer and hepatic FNH.