International Journal For Multidisciplinary Research

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Triple-Phase CT for Hepatic Lesions: A Comprehensive Review of Diagnostic Accuracy and Emerging Alternatives

Author(s) Mr. Bharat Bhushan Dagur, Ms. Rukamanee yadav
Country India
Abstract Introduction: Triple-phase contrast-enhanced CT (including non-contrast, arterial, and portal venous phases) remains a cornerstone in imaging hepatic lesions. It provides high diagnostic accuracy for both malignant lesions—such as hepatocellular carcinoma (HCC) and metastases—and benign liver lesions like hemangiomas and cysts.
Aim: To evaluate the diagnostic performance of triple-phase CT for hepatic lesions and compare it with emerging modalities such as contrast-enhanced MRI, CEUS, and PET imaging.
Objectives: To assess the pooled sensitivity, specificity, and accuracy of triple-phase CT for HCC, liver metastases, and benign hepatic lesions. To compare triple-phase CT with MRI, CEUS, and PET in detecting and characterizing hepatic lesions. To analyze subgroup performance in small lesions (<1 cm) and pediatric cases. To summarize meta-analysis results for improved clinical decision-making.
Methods and Materials: A narrative review and meta-analysis (2020–2025) of imaging studies on HCC, metastases, and benign hepatic lesions was conducted. Diagnostic accuracy metrics (sensitivity, specificity, accuracy) were extracted from selected studies. Pooled results were analyzed for lesion type and compared across imaging modalities, including triple-phase CT, contrast-enhanced MRI, CEUS, and novel PET tracers.
Results: Triple-phase CT demonstrated moderate sensitivity (~66–93%) and high specificity (>90%) for HCC. One study reported ~93% sensitivity and 92–93% specificity for CT in malignant hepatic lesions. Accuracy was ~90% for most lesions, especially hypervascular tumors. MRI (gadoxetic-acid–enhanced) and CEUS showed higher sensitivity (~82% and ~92%, respectively) but similar specificity. PET tracers (PSMA PET) demonstrated very high sensitivity (>90%) but variable specificity. CT accuracy decreased for small lesions (<1 cm) and in pediatric cases, where MRI or CEUS may be preferable.
Conclusion: Triple-phase CT remains a reliable and widely accessible imaging modality for hepatic lesion characterization. While MRI and CEUS offer higher sensitivity—especially for small or atypical lesions—CT continues to play a crucial role due to its speed and availability. Combined imaging strategies (CT + MRI/CEUS) provide optimal diagnostic accuracy.
Keywords Keywords: Triple-phase CT, Hepatic lesions, Hepatocellular carcinoma, Metastases, MRI, CEUS, PET, Diagnostic accuracy, Sensitivity, Specificity
Field Medical / Pharmacy
Published In Volume 7, Issue 4, July-August 2025
Published On 2025-07-20
DOI https://doi.org/10.36948/ijfmr.2025.v07i04.51739
Short DOI https://doi.org/g9t2db
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