THE ROLE OF COMPUTED TOMOGRAPHY IN THE DIAGNOSIS OF HEPATOCELLULAR CARCINOMA IN VIRAL HEPATITIS B AND C PATIENTS

Ateeque Ahmed Khan, Mahnoor Hafeez

Abstract


ABSTRACT

BACKGROUND: Hepatocellular carcinoma (HCC) is a major health problem worldwide. It is the fifth most common cancer in the world, and develops in a background of cirrhotic liver. Our objective was to determine the diagnostic accuracy of Triphasic MDCT in detection of hepatocellular carcinoma in hepatitis B and C patients, taking histopathology as gold standard. MATERIAL AND METHODS: The Cross Sectional study was performed on 183 patients at Department of Diagnostic Radiology and imaging, Civil Hospital Karachi for a period of eight months from June 2015 to February 2016. Standard MDCT technique is used for evaluation of ultrasound detected hepatic mass in patients with viral hepatitis B or C. Its enhancement pattern on arterial, portal and delayed phase were carefully evaluated and then compared with the histopathology. RESULTS: Mean age of the patients was 52.03±13.42 years. Gender distribution shows 128 patients (69.9%) were male while remaining 55 patients (30.1%) were female. Risk factor analysis demonstrated 53 Hepatitis B patients while 130 patients were Hepatitis C positive. True positive cases were 110 and false positive cases were only 2.  Positive predictive value was 98.2%, negative predictive value 94.4% with sensitivity 96.5%, specificity 97.1% and accuracy was found to be 96.7%. CONCLUSION: The results of this study suggest that CT Imaging proved high Sensitivity and positive predictive values in the detection of Hepatocellular Carcinoma taking histopathology as gold standard.

Key words: Hepatocellular Carcinoma, HCC, hepatitis B virus, HBV, hepatitis C virus, HCV, histopathology, MDCT, Triphasic CT liver


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