Diagnostic sensitivity of hepatocellular carcinoma imaging and its application to non‐cirrhotic patients

Abstract

We provide evidence that the sensitivity of HCC diagnosis by imaging is not influenced by the cirrhotic background. Further study is needed to validate the specificity and accuracy.

MR imaging features for improved diagnosis of hepatocellular carcinoma in the non-cirrhotic liver: Multi-center evaluation

“…Our results might partially explain the findings of previously published studies showing a poor diagnostic performance for HCC detection in non-cirrhotic livers compared to patients with liver cirrhosis (sensitivity, 56% versus 82%) 17 and of another study showing that 31% of HCC in patients with liver cirrhosis show no "wash-out" phenomenon 24 . This underlines that "classic" imaging features of HCC in the cirrhotic liver may not be applied for differentiation of malignant from benign hepatocellular tumors of the non-cirrhotic liver.…”

“…In these cases differentiation of malignant and benign hepatocellular tumors is primarily based on imaging features defined in the cirrhotic liver including arterialization of blood supply, focal fatty infiltration, encapsulation, portal or hepatic vein invasion, and portal venous shunting 15,16 . Although there is an overlap of imaging findings, significant differences exist in the MRI appearance of HCC between patients with and those without cirrhosis making the diagnosis of HCC in noncirrhotic livers difficult 17,18 .…”

Performance of Imaging Modalities in the Diagnosis of Hepatocellular Carcinoma: a Systematic Review and Meta-Analysis

“…The overall sensitivity and specificity derived by the pooled analysis were 0. 78 As a consequence, the use of US as a first-line evaluation in HCC screening can improve the overall accuracy and can reduce the rate of FN results in the following imaging modalities, such as CT and MRI. By considering only CEUS, an even better performance is expected.…”

Intrahepatic fetus: unusual image of an intratumoural haemorrhage

“…A diagnosis of HCC was confirmed by non-invasive criteria for diagnosing HCC recommended by both the American Association for the Study of Liver Diseases and the European Association for the Study of the Liver consensus statement. [1][2][3] This consisted of a serum α-fetoprotein level >200 ng/mL and a typical enhancement pattern (arterial enhancement and portal/delayed washed out) on dynamic imaging of the mass in a mildly cirrhotic liver. [1][2][3] This case demonstrated a rare cause of acute, right upper quadrant abdominal pain.…”