CT Detection of Hepatocellular Carcinoma in Advanced Liver Cirrhosis : Correlation of Helical CT and Explanted Liver

Korean J Hepatol > Volume 8(2); 2002 > Article

The Korean Journal of Hepatology 2002;8(2): 201-208.

원저 ( Original Articles ) : CT Detection of Hepatocellular Carcinoma in Advanced Liver Cirrhosis : Correlation of Helical CT and Explanted Liver

CT Detection of Hepatocellular Carcinoma in Advanced Liver Cirrhosis : Correlation of Helical CT and Explanted Liver

Jae Hoon Lim, M.D.1, Min Ju Kim, M.D.1 , Liu Wei Chiang, M.D., Hyo Keun Lim, M.D.1, Cheol Keun Park, M.D.2, Seung Woon Paik, M.D.3 , Kwang Cheol Koh, M.D.3, Jae-Won Joh, M.D.4

Departments of Radiology1, Diagnostic Pathology2, Gastroenterology3, General Surgery4, Samsung Medical Center, Sungkyunkwan University School of Medicine

ABSTRACT

Objective
The objective of this study was evaluate the diagnostic efficacy of three-phase helical dynamic CT in the detection of hepatocellular carcinomas in patients with advanced liver cirrhosis. Materials and Methods: Three-phase helical dynamic CT in 77 patients with advanced liver cirrhosis was evaluated prospectively before orthotopic liver transplantation. The histopathologically confirmed hepatocellular carcinomas in the explanted livers were compared with pretransplantation CT results by one-to-one correlation. Results: Histopathologic examination of the explanted livers revealed 72 hepatocellular carcinomas in 41 patients. The size of the hepatocellular carcinomas was 0.5-14.0 cm (mean, 1.6 cm). The use of helical dynamic CT enabled the detection of 38 of 72 hepatocellular carcinomas (sensitivity, 53%). Fifteen of 35 (43%) hepatocellular carcinomas smaller than 2 cm and 23 of 37 (62%), hepatocellular carcinomas ranging from 2.0 cm to 14.0 cm were detected. Patient sensitivity and specificity in the detection of hepatocellular carcinoma were 81% (33/41) and 94% (34/36), respectively. Conclusions: Three-phase helical dynamic CT is insensitive for detection of hepatocellular carcinomas in patients with advanced liver cirrhosis, especially for hepatocellular carcinomas smaller than 2 cm.(Korean J Hepatol 2002;8:201-208)

KeyWords: Computed tomography (CT), clinical effectiveness