Diagnostic accuracy of color Doppler in diagnosis of Hepatocellular carcinoma taking histopathology as gold standard

Abstract

Hepatocellular carcinoma (HCC) is the fifth most common cancer in the world and the third most common cause of cancer mortality. Despite the high numbers of patients diagnosed worldwide, HCC continues to pose challenging clinical problems. Good-quality ultra sound with careful evaluation of the entire liver can be a screening examination for HCC in patients at risk. The aim of the study was to determine the diagnostic accuracy of the Doppler sonography for differentiation of hepatocellular carcinoma (HCC) from other focal liver lesions by taking histopathology as a gold standard. It was a cross-sectional survey, conducted in the Department of Diagnostic Radiology, King Edward Medical University/Mayo Hospital, Lahore in one year from 13-12-2010 to 12-12-2011. A total of 70 patients were included in this study with focal lesions on ultrasound are included while pregnant patients are excluded. After evaluating by Doppler sonography and doing core biopsy, the patients were sent to the Department of Pathology, Mayo Hospital for histopathological examination. Histopathology was assessed for confirmation of positive and negative cases. Mean age of the patients was 60.9 ± 4.7 years. Out of 70 patients, 47 patients (67.1%) were male while remaining 23 patients (32.9%) were female. On Doppler sonography 37 cases were positive for hepatocellular carcinoma and 33 cases were negative while 36 cases were positive and 34 negative on histopathology. On Doppler sonography, sensitivity (94.4%), specificity (91.1%), diagnostic accuracy (92.8%), positive predictive value (91.8%) and negative predictive value was 93.9%. We concluded that Doppler sonography is a useful method for differen-tiation of Hepatocellular carcinoma from other focal liver lesions, detection and characterization of hepatocellular carcinoma.

Diagnostic Accuracy of Ultrasound in Detecting Hepatocellular Carcinoma Keeping Histopathology as Gold Standard

“…In a Cross-sectional survey 24 , conducted in the Department of Diagnostic Radiology, King Edward Medical University/Mayo Hospital, Lahore in one year included a total of 70 patients with focal lesion on ultrasound. After evaluating by Doppler sonography and doing core biopsy, the patients were sent to the department of pathology in Meyo hospital for Histopathological examination.…”

“…On Doppler sonography, sensitivity (94.4%), specificity (91.1%), diagnostic accuracy (92.8%), positive predictive value (91.8%) and negative predictive value was 93.9%. 24 In a study by Yu, et al 25 , which compared the different imaging modalities like US, CT and MRI, the sensitivity of USG in comparison to these varied from 46-85% depending upon the lesion size. It was lowest for the lesion size less than 2 cm which was 46% and with the lesion size greater than 4 cm it was 85%.…”