Surgically staged focal liver lesions: Accuracy and reproducibility of dual-phase helical CT for detection and characterization

Ihab R. Kamel, Michael A. Choti, Karen M. Horton, H. J V Braga, Bernard A. Birnbaum, Elliot K. Fishman, Richard E. Thompson, David A. Bluemke

Research output: Contribution to journalArticlepeer-review

70 Scopus citations


PURPOSE: To assess the accuracy and reproducibility of dual-phase helical computed tomography (CT) in enabling preoperative detection and characterization of surgically staged focal liver lesions. MATERIALS AND METHODS: Surgically and histopathologically proven liver lesions were evaluated by three experienced CT readers. These lesions were present in 77 patients who underwent dual-phase helical CT. Images were interpreted separately by the three blinded reviewers. Each lesion was graded on a nine-point scale of confidence, with 1 being definitely benign, 9 being definitely malignant, and 5 being indeterminate. The χ2 test was used to determine if the distribution of lesion classifications was different between readers. RESULTS: There was a total of 237 lesions: 73 were benign and 164 were malignant. Sensitivity for lesion detection was 69%, 70%, and 71% for the three reviewers, respectively. Specificity was 91%, 86%, and 90%, and the area under the curve for the alternative-free response receiver operating characteristic curve was 0.84, 0.83, and 0.85, respectively. The difference in the distributions of lesion classification between the three reviewers was not statistically significant (P = .67) as determined by χ2 analysis. CONCLUSION: Dual-phase CT has sensitivity of 69%-71% and high specificity (86%-91%) in enabling the detection and characterization of focal liver lesions. Interpretation is highly reproducible, as there is minimal variation between experienced reviewers.

Original languageEnglish (US)
Pages (from-to)752-757
Number of pages6
Issue number3
StatePublished - Jun 1 2003


  • Liver neoplasms, CT
  • Liver neoplasms, diagnosis
  • Liver neoplasms, metastases

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging


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