DIAGNOSTIC ACCURACY OF ULTRASONOGRAPHY FOR DIAGNOSIS OF HEPATOCELLULAR CARCINOMA IN PATIENTS WITH LIVER CIRRHOSIS

Objective: To determine the diagnostic accuracy of USG for diagnosis of hepatocellular carcinoma in comparison to histopathology taking it is as gold standard, in patients with liver cirrhosis. Study Design: Cross – sectional. Place and Duration of Study: Radiology Department of Combined Military Hospital, Lahore, from 15 Nov., 2009 to 15 May 2010. Patients and Methods: Seventy patients with liver cirrhosis with a known mass, referred to the Radiology department, fulfilling the inclusion criteria were included. Ultrasonography was done with TOSHIBA NEMIO and LOGIC 2000 ultrasound machines, using low frequency curvilinear probe with a frequency of 3.5 MHz. Ultrasound guided aspiration was performed using an 18G needle under full aseptic measures. Ultrasonographic findings were validated by histopathology reports. Results: Mean age of the study population was 60.39 ± 10.9 years. 47 (67.1%) of the patients were males and 23 (32.9%) were females. Risk factors for hepatocellular carcinoma were HCV infection in 27 (38.6%), HBV infection in 11 (15.7%). Mean size of the lesions was 4.59 ± 1.08 cm. The lesions were characterized as being isoechoic, hypoechoic or hyperechoic as compared to the liver parenchyma. Compared to histopathologic findings, accuracy of the ultrasound findings was determined. Sensitivity of ultrasonography in detection of hepatocellular carcinoma was 92.3%. Specificity was 55.5%. Positive predictive value was 85.7% and negative predictive value was 71.4%. Conclusion: Conventional ultrasonography can be used as a screening tool in patients with advanced liver cirrhosis and for surveillance purposes. However further workup is required for definitive diagnosis.