Diagnostic Performance of Quadruple Phase Multidetector Row Computed Tomography in Hepatoma: Comparison with Histopathological Diagnosis
Keywords:
Hepatocellular carcinoma, Computed Tomography, Diagnostic accuracyAbstract
Objective: To determine diagnostic accuracy of quadruple phase helical computed tomography scan in detection of hepatocellular carcinoma in individuals with hepatitis B and C, keeping histopathology as the gold standard.
Methods: A cross-sectional study was performed in the Radiology and Imaging department of a tertiary care university hospital during 2014 to 2016. All serologically positive patients were included. Quadruple phase computed tomography scan was done and results were interrelated with histological diagnosis.
Results: Hepatocellular carcinoma was accurately diagnosed in 76 out of 80 patients using Quadruple phase computed tomography scan (sensitivity, 95%). It was correctly excluded in 70 of 72 patients (specificity, 97.2%). The overall diagnostic accuracy of Quadruple phase computed tomography scan for diagnosing hepatocellular carcinoma was 96.05%. The positive and negative predictive values were 97.4% and 94.59% respectively.
Conclusion: Quadruple phase computed tomography is more effective in evaluating hepatocellular carcinoma than conventional biphasic and triphasic computed tomography scans. We propose it as the technique of first preference for imaging workup in patients with Hepatitis B and C.
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Colli A, Fraquelli M, Casazza G, Massironi S, Colucci A, Conte D, et al. Accuracy of ultrasonography,spiral CT, magnetic resonance, and alpha-fetoprotein in diagnosing hepatocellular carcinoma: a systematic review. Am J Gastroenterol 2006; 101:513-23.
Laghi A, Lannaccone R, Rossi P, Carbone L, Ferrari R, Mangiapane F, et al. Hepatocellular carcinoma: Detection with tripple-phase multi-detector row helical CT in patients with chronic hepatitis. Radiol 2003; 226:543-9.
Lannaccone R, Laghi A, Catalano C, Rossi P, angiapane F, Murakami T, et al. Hepatocellular carcinoma: Role of unenhanced and delayed phase multi-detector row helical CT in patients with cirrhosis. Radiol 2005; 234: 460-7.
Soyer P, Poccard M, Boudiaf M, Abitbol M, Hamzi L, Panis Y, et al. Detection of hypovascular hepatic metastases at triple-phase helical CT: Sensitivity of phases and comparison with surgical and histopathologic finding. Radiol 2004; 231:413-20.
Saar B, Kellener-Weldon F. Radiological diagnosis of hepatocellular carcinoma. Liver Int 2008; 28:189-99.
Yaqoob J, Bari V, Usman MU, Munir K, Mosharaf F, Akhtar W. The evaluation of hepatocellular carcinoma with biphasic contrast enhanced helical CT scan.2004; 54:123-7.
Yang JD, Roberts LR. Hepatocellular carcinoma: a global view. Nat Rev Gastroenterol Hepatol 2010; 7:448-58.
Parkin DM, Bray F, Ferlay J. Global cancer statistics, 2002. CA Cancer J Clin 2005; 55:74-108.
Bosch FX, Ribes J, Diaz M. Primary liver cancer: worldwide incidence and trends. Gastroenterol 2004; 127:5-16.
Mitsuzaki K, Yamashita Y, Ogata I. Multiphase helical CT of the liver for detecting small hepatomas in patients with liver cirrhosis: Contrast injection protocol and optimal timing. Am J Roentgenol 1996; 167:753-7.
Kim HC, Kim AY, Han JK. Hepatic arterial and portal venous phase helical CT in patients treated with transcatheter arterial hemoembolization forhepatocellular carcinoma: added value of unenhanced images. Radiolo 2002; 225:773-80.
Lim JH, Choi D, Kim SH, Lee SJ, Lee WJ, Lim HK et al. Detection of hepatocellular carcinoma: Value of adding delayed phase imaging to dual-phase helical CT. Am J Roentgenol 2002; 179: 67-73.
Beasley RP. Hepatitis B virus. The major etiology of hepatocellular carcinoma. Cancer 1988; 61:1942-56.
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Copyright (c) 2021 Saadia Sarwar Soomro, Muhammad Saad Ahmed, Sheeza Imtiaz, Waseem Mehmood Nizamani, Muhammad Kashif Shazlee, Saifullah Obaidullah
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