Is Ultrasound a Viable Imaging Modality for the Diagnosis of Hepatocellular Carcinoma? A Cross-Sectional Study

  • Reeta Rani Assistant Professor, Department of Radiology, Shaheed Mohtarma Benazir Bhutto Medical College, Lyari Pakistan
  • Uzma Mumtaz Instructor, Department of Radiology, Sindh Government Lyari General Hospital, Karachi Pakistan
  • Amjad Shah Senior Registrar, Department of Radiology, Shaheed Mohtarma Benazir Bhutto Medical College, Lyari Pakistan
  • Aamna Qazi Resident Medical Officer, Medical Unit III Dr. Ruth K.M. Pfau Civil Hospital, Karachi Pakistan
  • Afshan Shaikh Instructor Radiology Department, The Aga Khan University Hospital, Karachi Pakistan
  • Syed Muhammad Kashif Assistant Professor, Department of Medicine Dow University of Health Sciences, Karachi Pakistan
Keywords: Cirrhotic patients, Diagnostic accuracy, Magnetic resonance imaging, Hepatocellular carcinoma, Ultrasonography

Abstract

Background: Radiologists are always questioning the use of an imagine modality as compared to the other, this study helps answer that question for the diagnosis of Hepatocellular carcinoma. Objective: To compare the use of MRI imaging technique with ultrasonography for the diagnosis of hepatocellular carcinoma. Study Design: The type of study is a Prospective Cross-Sectional study. Settings: A large tertiary care hospital in Karachi, Pakistan. Duration: One year from July 2018 to July 2019. Methodology: The inclusion criteria was all the patients who were referred to us with symptoms for concern for hepatic tumors. For the MRI we used a 1.5 tesla machine, and for the ultrasound we used a conventional grey scale ultrasonography with a probe of 5 MHz. We performed multiphasic contrast enhanced MRI’s, with images taken both before the injection of the contrast and afterwards in the various phases such as the arterial phase, portal venous phase and finally the delayed phase respectively. Results: The study population consisted of n=110 patients having a mean age of 46.5 +/- 5.50 years. There were n= 78 (70.90%) males and n= 32 (20.09%) females. N= 101 (91.81%) patients had a diagnosis of hepatocellular carcinoma as per MRI scan, for ultrasound n= 47 (42.72%) patients were diagnosed as true positive, n= 2 (1.81%) were false positive, n= 54 (49.09%) were false negative, while n= 7 (6.36%) cases were truly negative. The specificity was 77.77% the sensitivity was 46.53%, the positive predictive value was 95.91%, negative predictive value was 11.4%, and accuracy was 49.09% respectively. Conclusion: We found that the specificity of ultrasound as a diagnostic modality for hepatocellular carcinoma as compared to the MRI scan is good, however it is only able to correctly identify about half the patients, hence care should be taken when interpreting the results of ultrasound for hepatocellular carcinoma.

Published
2021-03-31
How to Cite
Rani, R., Mumtaz, U., Shah, A., Qazi, A., Shaikh, A., & Kashif, S. M. (2021). Is Ultrasound a Viable Imaging Modality for the Diagnosis of Hepatocellular Carcinoma? A Cross-Sectional Study. Annals of Punjab Medical College, 15(1), 9-11. https://doi.org/10.29054/apmc/2021.1089