Abstract: This study investigated the relationship between the quantitative parameters of computed tomography (CT) spectroscopy technology and alpha-fetoprotein (AFP), abnormal prothrombin (des-γ-carboxyprothrombin, DCP) and the diagnostic efficiency of hepatocellular carcinoma (HCC). Sixty-one patients with HCC (HCC group) and 61 patients with benign liver lesions (benign group) were selected as the study subjects. The lesion-liver contrast noise ratio (CNR), calcium (fat) concentration, fat (calcium) concentration, water iodine concentration, lesion-to-normal hepatic tissue ratio (LNR) and normalized iodine concentration (NIC) were compared between the two groups at a single energy level of 40-140 keV in arterial phase and portal vein phase. The results showed that the arterial phase two groups had the best CNR up to 50 keV, and the portal phase HCC group had the best CNR up to 70 keV. The arterial phase and portal phase calcium (fat) concentration, LNR, and NIC of the HCC group were lower than those of the benign group. The concentration of fat (calcium) was higher than that of the benign group (P<0.05), and each index was significantly correlated with AFP and DCP (P<0.05). The AUC of the CNR of 50 keV in the arterial phase combined with the arterial NIC for the diagnosis of HCC was 0.935. Therefore, the best single-energy image can be obtained by detecting the best CNR by CT spectroscopy. The 50 keV CNR and NIC in the arterial phase are related to AFP and DCP. The combined detection can 301 be used as a non-invasive method for diagnosing HCC.

Key words: CT spectroscopy, alpha-fetoprotein, abnormal prothrombin, liver cancer