64 slice ct scanner

CT images were acquired using six different CT scanners from four institutions. All patients received a preoperative abdominal contrast-enhanced CT scan. Contrast-enhanced CT examinations in Institution I were conducted using three CT scanners, including a 64-slice and a 256-slice CT scanner (Philips Healthcare), as well as a 16-slice CT scanner (Toshiba Medical System). In Institution II, the CT scans were performed using two CT scanners, including a 64-slice CT scanner (Siemens Healthineers) and a 16-slice CT scanner (Philips Healthcare). The CT scans in Institution III were undertaken using a 64-slice CT scanner (GE Healthcare). The CT scans in Institution IV were conducted using a 256-slice CT scanner (Philips Healthcare). Mean acquisition parameters in the four institutions were: tube voltage of 120 kev (100–130 kev), tube current of 213 mAs (125–300 mAs), pitch of 0.6 to 1.25 mm, slice thickness of 3 to 5 mm, and reconstruction interval of 3 to 5 mm. The contrast agents (Bayer Schering Pharma) were bolus-injected (1.5 mL/kg) at the rate of 2.5–3.5 ml/s with a high-pressure syringe. CT scans of the arterial phase and portal venous phase were carried out at 25 to 35 seconds and 55 to 75 seconds after injection, respectively.

[¹⁸F]FDG-PET/CT image acquisition was performed according to the European Association of Nuclear Medicine (EANM) guidelines (Boellaard et al. 2014 (link)). Images were acquired 60 ± 5 min after [¹⁸F]FDG administration, in the fasting state using an integrated PET/CT scanner, either a Siemens Biograph LS 6 scanner (Siemens, Munich, Germany) equipped with LSO crystals and a six-slice CT scanner, or a GE Discovery PET/CT 690 equipped with LYSO crystals and a 64-slice CT scanner (General Electric Healthcare, Waukesha, WI, USA). Both scanners are EARL certified (http://www.eanm.org) and images were processed in order to minimize differences between semi-quantitative evaluation.

The patients underwent a physical examination conducted by specialist physicians, and blood, liver and kidney function, blood ammonia, autoantibody series, serum copper, ceruloplasmin, hepatitis biomarker and coagulation tests were also performed. Electronic gastroscopy was performed by experts at the 302 Hospital of the People’s Liberation Army on an Olympus Q260 type gastroscope (Olympus, Tokyo, Japan). Abdominal helical CT scans were conducted using a 64-slice CT scanner (GE Healthcare, Cleveland, OH, USA) and the images were analyzed using AW4.5 working platform Volume Viewer 5-D post-processing software for 3D vascular reconstruction (GE Healthcare). The diagnosis was made by two experienced radiologists.