2003
DOI: 10.1007/s00330-002-1814-3
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Poor sensitivity of sonography in detection of hepatocellular carcinoma in advanced liver cirrhosis: accuracy of pretransplantation sonography in 118 patients

Abstract: The objective of this study was to assess the detectability of hepatocellular carcinoma by sonography in advanced cirrhotic patients undergoing liver transplantation. We retrospectively reviewed pretransplantation sonography in 118 consecutive patients with advanced liver cirrhosis. We assessed the detectability of hepatocellular carcinoma in relation to tumor size, location, total liver volume, and degree of sonographic heterogeneity of the liver parenchyma. On pathologic examination, 51 hepatocellular carcin… Show more

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Cited by 51 publications
(52 citation statements)
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References 17 publications
(32 reference statements)
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“…Although this is at the pessimistic end of the range of available evidence, it should not be seen as an outlying estimate. Every study that has used an optimal reference standard (explant pathology) to investigate the diagnostic capabilities of US, in this setting, has reported disappointing sensitivity for the tumours p2 cm in diameter: 13.8% (Kim et al, 2001), 22.2% (Rode et al, 2001) and 30.0% (Liu et al, 2003). Even if one was to adopt the most positive estimate available, all robust evidence suggests that US is less sensitive than AFP assay for the detection of the smallest tumours.…”
Section: Interpretation Of Findingsmentioning
confidence: 99%
“…Although this is at the pessimistic end of the range of available evidence, it should not be seen as an outlying estimate. Every study that has used an optimal reference standard (explant pathology) to investigate the diagnostic capabilities of US, in this setting, has reported disappointing sensitivity for the tumours p2 cm in diameter: 13.8% (Kim et al, 2001), 22.2% (Rode et al, 2001) and 30.0% (Liu et al, 2003). Even if one was to adopt the most positive estimate available, all robust evidence suggests that US is less sensitive than AFP assay for the detection of the smallest tumours.…”
Section: Interpretation Of Findingsmentioning
confidence: 99%
“…False-positive results are less pervasive: the same studies report specificities in the range 92-98%. [256][257][258][259][260][261][262] There is good evidence that larger lesions are more reliably identified on ultrasonography. In Bennett and co-workers' study, sensitivities for the detection of HCCs of diameter greater than 5 cm, 3-5 cm, 2-3 cm, 1-2 cm and less than 1 cm were 75%, 50%, 20%, 13.6% and 0%, respectively.…”
Section: Ultrasonographymentioning
confidence: 99%
“…256 Other teams have found a similar correlation between tumour size and ultrasound sensitivity. 258,259,261 The technology of ultrasound diagnosis is evolving rapidly; it is anticipated that advances such as microbubble contrast enhancement and harmonic imaging techniques will significantly improve early detection rates in coming years. [263][264][265][266] There is also a possibility that these developments will raise false-positive findings.…”
Section: Ultrasonographymentioning
confidence: 99%
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“…The sensitivity of US for the detection of HCC is directly related to tumor size. Its diagnostic sensitivity for tumors smaller than 1 cm is about 42% (7,8) and reaches 95% for tumors of larger size (9). To confirm the suspicion of HCC by US in a patient with cirrhosis of the liver, the use of computed tomography (CT) is suggested (9).…”
Section: Introductionmentioning
confidence: 99%