Accuracy of Ultrasonography, Spiral CT, Magnetic Resonance, and Alpha-Fetoprotein in Diagnosing Hepatocellular Carcinoma: A Systematic Review. CME

Abstract

US is highly specific but insufficiently sensitive to detect HCC in many cirrhotics or to support an effective surveillance program. The operative characteristics of CT are comparable, whereas MRI is more sensitive. High-quality prospective studies are needed to define the actual diagnostic role of AFP.

Asian Pacific Association for the Study of the Liver consensus recommendations on hepatocellular carcinoma

“…A study of systematic review on the accuracies of US, spiral CT, and MRI in diagnosing HCC in patients with chronic liver disease revealed that the pooled estimates of the 14 US studies showed a sensitivity of 60% and specificity of 97%; for the ten CT studies, sensitivity was 68% and specificity 93%; and for the nine MRI studies, sensitivity was 81% and specificity 85% [203]. The operative characteristics of CT are comparable, whereas MRI is more sensitive.…”

Is tumor biopsy necessary?

“…In all, 480 articles were identified (Supporting Table 1), and they included a systematic review by Colli et al 31 This review covers the literature from 1966 to December 2004 and includes 24 studies evaluating the diagnostic accuracy of US, computed tomography (CT), and magnetic resonance imaging (MRI; see Table 5 and Supporting Tables 4-6). These studies were mostly prospective or retrospective cross-sectional studies in which the patients were consecutively included; the reference standard was the explanted liver in a large majority of the studies and was less frequently biopsy or clinical follow-up.…”

Circulating microRNA profiles in plasma: identification of miR-224 as a novel diagnostic biomarker in hepatocellular carcinoma independent of hepatic function

“…The sensitivity for HCC detection in plasma miR-224 was 78.7-90.7% (Table 2). This result indicates that the sensitivity of plasma miR-224 was not inferior to that of recent imaging modalities such as ultrasonography, computed tomography (CT), gadolinium ethoxybenzyl diethlenetriamine pentaacetic acid-enhanced liver magnetic resonance imaging (Gd-EOB-DTPA-enhanced MRI), their sensitivities were 60.5%, 76.0% and 88.5%, respectively [81][82][83]. Moreover, plasma miR-224 may be an indicator of residual tumor in non-surgical treatment such as percutaneous ablation therapy and/or TACE although this was preliminary result because the number of cases was small (Figure 7).…”