Retrospective Evaluation of Discrepancies between Radiological and Pathological Size of Hepatocellular Carcinoma Masses

Abstract

Asian Pac J Cancer Prev, 15 (21), 9487-9494 IntroductionTumor size of hepatocellular carcinoma (HCC) is an important indicator for prognostic assessment and the choice of treatment, and also be a critical variable in staging systems. Although the prognosis of HCC is extremely complicated and depends not only on the stage of the tumor, but also on the residual liver function and serum a-fetoprotein (AFP) levels (Xu et al., 2012) AbstractBackground: The size of a hepatic neoplasm is critical for staging, prognosis and selection of appropriate treatment. Our study aimed to compare the radiological size of solid hepatocellular carcinoma (HCC) masses on magnetic resonance imaging (MRI) with the pathological size in a Chinese population, and to elucidate discrepancies. Materials and Methods: A total of 178 consecutive patients diagnosed with HCC who underwent curative hepatic resection after enhanced MRI between July 2010 and October 2013 were retrospectively identified and analyzed. Pathological data of the whole removed tumors wereassessed and differences between radiological and pathological tumor size were identified. All patients were restaged using a modified Tumor-Node-Metastasis (TNM) staging system postoperatively according to the maximum diameter alteration. The lesions were classified as hypo-staged, iso-staged or hyper-staged for qualitative assessment. In the quantitative analysis, the relative pre and postoperative tumor size contrast ratio (%∆size) was also computed according to size intervals. In addition, the relationship between radiological and pathological tumor diameter variation and histologic grade was analyzed. Results: Pathological examination showed 85 (47.8%) patients were overestimated, 82 (46.1%) patients underestimated, while accurate measurement by MRI was found in 11 (6.2%) patients. Among the total subjects, 14 (7.9%) patients were hypo-staged and 15 (8.4%) were hyper-staged post-operatively. Accuracy of MRI for calculation and characterized staging was related to the lesion size, ranging from 83.1% to 87.4% (<2cm to ≥5cm, p=0.328) and from 62.5% to 89.1% (cT1 to cT4, p=0.006), respectively. Overall, MRI misjudged pathological size by 6.0 mm (p=0.588 ), and the greatest difference was observed in tumors <2cm (3.6 mm, %∆size=16.9%, p=0.028). No statistically significant difference was observed for moderately differentiated HCC (5.5mm, p=0.781). However, for well differentiated and poorly differentiated cases, radiographic tumor maximum diameter was significantly larger than the pathological maximum diameter by 3.15 mm and underestimated by 4.51 mm, respectively (p=0.034 and 0.020). Conclusions: A preoperative HCC tumor size measurement using MRI can provide relatively acceptable accuracy but may give rise to discrepancy in tumors in a certain size range or histologic grade. In pathological well differentiated subjects, the pathological tumor size was significantly overestimated, but underestimated in poorly differentiated HCC. The difference between radiological and pathological tumor ...

The value of neutrophil to lymphocyte ratio and gamma-glutamyl transpeptidase to platelet ratio in patients with hepatocellular carcinoma

“…Edmondson–Steiner grades, Child-Pugh grades, and tumor size were closely related to HCC. [18–20] Songlin et al [21] revealed the association between AFP and clinicopathological features of HCC, including Child-Pugh grades and tumor size, which was consistent with our findings. In other studies, the relationship between hematologic parameters (NLR and GPR) and clinical characteristics (Child-Pugh grades and tumor size) has been demonstrated.…”

Diagnostic value of gamma‐glutamyl transpeptidase to alkaline phosphatase ratio combined with gamma‐glutamyl transpeptidase to aspartate aminotransferase ratio and alanine aminotransferase to aspartate aminotransferase ratio in alpha‐fetoprotein‐negative hepatocellular carcinoma

“…Child‐Pugh grades, and tumor size were closely related to HCC. 30 , 31 , 32 Songlin et al 33 revealed the association between AFP and clinicopathological features of HCC, including Child‐Pugh grades and tumor size, which was consistent with our findings. In other studies, the relationship between hematologic parameters (GAR and GAPR) and clinical characteristics (Child‐Pugh grades and tumor size) have been demonstrated.…”

Pancreatic Cyst Size Measurement on Magnetic Resonance Imaging Compared to Pathology

“…Previous studies show a discrepancy between radiological and pathologic size measurements of hepatic and renal tumors and, likewise, studies involving pancreatic tumors have illustrated a similar lack of correlation between radiological measurement and pathologic size [ 18 , 30 , 31 , 32 , 33 ]. For example, Maimone et al used MRCP to measure IPMN long-axis diameter in comparison to pathology and reported size differences ranging from 2–44 mm with a mean difference of 5.88 mm, while Lee, Y.S.…”