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CT, MRI pelvic scans result in limited new findings in patients with HCC

Computerized tomography and magnetic resonance imaging pelvic scans resulted in limited new findings of lesions or metastatic disease in patients with hepatocellular carcinoma, researchers reported in a recently published study.

“The use of CT or [MRI] to image not only the abdomen but also the pelvis can carry disadvantages. CT can be performed quickly but is limited by its associated dose of radiation. In contrast, [MRI] imaging does not administer radiation but has a longer duration than CT. These examinations also often incur a high financial cost,” Janio Szklaruk, MD, PhD, from the University of Texas, and colleagues wrote. “To evaluate the added value of the pelvic portion of the examination in patients with a primary diagnosis of HCC, we retrospectively reviewed radiology reports in HCC patients who underwent imaging of the abdomen and pelvis.”

The researchers reviewed retrospective data of 478 patients with HCC who underwent abdominal and pelvic examinations with CT (n = 248) or MRI (n = 230) scanning between March 2015 and March 2016. The proportion of known findings from patient records was compared with the number of new findings in the 2015 to 2016 period.

In total, 385 patients had no findings using CT (81.5%) or MRI (79.6%) vs. 93 patients who had findings in the pelvis. The findings included bone metastases or suspected bone metastases (n = 31), ascites (n = 27), suspected implants (n = 7) and bladder wall thickening (n = 5).

There were 11 new findings using CT and 15 using MRI, which included 10 patients with bone metastases or suspected metastases and two patients with ascites.

“Our results indicate that in most cases, the examination of the pelvis in patients with a diagnosis of HCC yields limited new findings. On the basis of these results, one may consider eliminating the pelvic portion of the imaging in the absence of signs and symptoms related to the pelvis,” the researchers concluded. “The elimination of the pelvic portion from the examination of the abdomen and pelvis using CT or [MRI] should improve image quality, shorten exam times, and, in the case of CT, decrease radiation dose. Forgoing the pelvic portion also would reduce interpretation time and radiologist fatigue. – by Talitha Bennett

Disclosure: The researchers report no relevant financial disclosures.