ROLE OF TRIPLE-PHASE CT IN THE DETECTION AND CHARACTERIZATION OF FOCAL HEPATIC LESIONS: A SYSTEMATIC REVIEW

Abstract

Focal hepatic lesions comprise a broad spectrum of benign and malignant abnormalities that require accurate detection and characterization for appropriate clinical management. Triple-phase computed tomography (CT) provides phase specific information through arterial, portal venous, and delayed imaging. To systematically evaluate the role of triple phase CT in the detection, characterization, and differentiation of focal hepatic lesions. A systematic literature review was conducted according to PRISMA 2020 guidelines. PubMed, ScienceDirect, Google Scholar and DOAJ were searched for relevant studies published between 2017 and 2026. Ten eligible clinical studies were included. Methodological quality was assessed using QUADAS-2, and findings were synthesized narratively. Triple-phase CT consistently improved lesion assessment by combining complementary enhancement information. The arterial phase was most useful for hypervascular lesions, the portal venous phase improved visualization of hypovascular lesions and metastases, and the delayed phase aided evaluation of washout, capsule formation, progressive fill-in, and delayed enhancement. Diagnostic performance was generally favorable, although variability existed according to lesion type, CT protocol, and confirmation method. Triple-phase CT is a clinically useful and reliable modality for comprehensive evaluation of focal hepatic lesions and supports effective benign–malignant differentiation.