CT detection of hepatocellular carcinoma in advanced liver cirrhosis: correlation of helical CT and explanted liver.

Objective: The objective of this study was evaluate the diagnostic efficacy of three-phase helical dynamic CT in the detection of hepatocellular carcinomas in patients with advanced liver cirrhosis.

Materials And Methods: Three-phase helical dynamic CT in 77 patients with advanced liver cirrhosis was evaluated prospectively before orthotopic liver transplantation. The histopathologically confirmed hepatocellular carcinomas in the explanted livers were compared with pretransplantation CT results by one-to-one correlation.

Results: Histopathologic examination of the explanted livers revealed 72 hepatocellular carcinomas in 41 patients. The size of the hepatocellular carcinomas was 0.5-14.0 cm (mean, 1.6 cm). The use of helical dynamic CT enabled the detection of 38 of 72 hepatocellular carcinomas (sensitivity, 53%). Fifteen of 35 (43%) hepatocellular carcinomas smaller than 2 cm and 23 of 37 (62%), hepatocellular carcinomas ranging from 2.0 cm to 14.0 cm were detected. Patient sensitivity and specificity in the detection of hepatocellular carcinoma were 81% (33/41) and 94% (34/36), respectively.

Conclusions: Three-phase helical dynamic CT is insensitive for detection of hepatocellular carcinomas in patients with advanced liver cirrhosis, especially for hepatocellular carcinomas smaller than 2 cm.