Introduction: Liver is an important constituent of the digestive tract and is involved in maintenance of the body’s metabolic homeostasis. Liver cancer is a major cancer in less developed countries where 83% of worldwide incidence of new cases has been reported with China alone accounting for nearly 50% of new incident cases of liver cancer. As per an estimate about 7 Lakhs death due to hepatocellular carcinoma occur annually.
Aim: To compare the imaging findings of focal hepatic lesions by dual-energy computed tomography, multi-detector computed tomography, and ultrasonography and its follow up by medical treatment/aspiration/biopsy.
Methods: All individuals with suggested liver illness and undergoing liver imaging were included and all of them underwent Ultrasound, MDCT and DECT protocol. Analysis of radiological images and/or verification of the lesion type by biopsy/ aspiration, surgery, or follow-up was done.
Results: Though majority of the malignancies were detected by the USG (75.0%), USG underdiagnosed malignancies in 3 of the cases. Diagnostic accuracy of USG was found to be 93.8%. Though majority of the malignancies were detected by MDCT (91.7%), MDCT undiagnosed malignancies in 1 of the cases. Diagnostic accuracy of MDCT was found to be 98.5%. All the cases with malignancies were accurately detected by the DECT (100.0%), all Benign cases were also accurately detected by DECT (100.0%). Thus, Diagnostic accuracy of DECT was found to be 100.0% with the help of iodine concentration mapping.
Conclusion: In this study, we have concluded that iodine quantification using dual energy computed tomography is helpful in characterisation and follow-up after treatment of liver lesions. Thus DECT with the help of iodine quantification can be used as a highly specific and sensitive imaging modality for malignant and benign liver lesions as compared to MDCT and USG.