Chronic Hepatitis C Virus Infection: Detection of Hepatocellular Carcinoma by Means of Contrast-Enhanced Color Doppler Liver Sonography

Detection and characterization of focal liver lesions are critical for patients with liver cirrhosis. The potential of contrast-enhanced sonography in the characterization of focal liver lesions is well established in the literature. However, prospective studies in the assessment of patients with suspected hepatocellular carcinoma (HCC) in liver cirrhosis are rare. B-mode imaging often cannot differentiate small focal lesions in cirrhotic livers. Also, power Doppler is not capable of characterizing small focal lesions in cirrhosis. Contrast-enhanced sonography with a first-generation enhancer seems to improve the accuracy of diagnosis of small HCC. The differentiation of HCC and dysplastic nodules is notoriously difficult. In addition, other arterial hypervascularized liver lesions should be considered, depending on the clinical background. The limitations and drawbacks of contrast-enhanced sonography should be considered. All imaging methods are of limited value in the detection of solid liver lesions smaller than 1 cm.

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Systematic review of radiological imaging for hepatocellular carcinoma in cirrhotic patients

Fung

Li²,

Raimondo³

et al. 2004

BJR

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We systematically reviewed the evidence for determining the best radiological imaging for characterizing hepatocellular carcinoma (HCC) in cirrhotic patients in 997 articles between 1995 and 2001. We selected only prospective and retrospective cohorts of patients, excluding both case reports and studies without separate data on HCC. Only 29 studies, comprising 918 patients, fulfilled the inclusion criteria: 10 used the explanted liver as the reference standard of diagnosis. All except one, either found no statistically significant difference between imaging modalities or had no direct comparison of sensitivity between different modalities of imaging; 16 studies evaluated HCC among cirrhotic patients and had biopsy or imaging as the reference standard for diagnosis. However, no one imaging technique was shown to be superior. In two studies, data of a HCC subgroup was derived from the studies evaluating different kinds of focal hepatic lesions. No conclusion could be drawn because of the small sample size. One study addressed the issue of therapeutic impact. The evidence for choosing the best modality of imaging for characterizing HCC in cirrhotic patients is inadequate. Large multicentre studies with defined reference standards for diagnosis, and studies evaluating therapeutic impact are needed.

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Chronic Hepatitis C Virus Infection: Detection of Hepatocellular Carcinoma by Means of Contrast-Enhanced Color Doppler Liver Sonography

Cited by 3 publications

References 8 publications

Doppler in hepatic cirrhosis and chronic hepatitis

Doppler in hepatic cirrhosis and chronic hepatitis

Small hepatocellular carcinomas in patients with liver cirrhosis

Systematic review of radiological imaging for hepatocellular carcinoma in cirrhotic patients

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