Effectiveness of preoperative multidetector computed tomography in the diagnosis of hepatocellular carcinoma in patients undergoing transplantation for liver cirrhosis

Effectiveness of preoperative multidetector computed tomography (MDCT) in the diagnosis of hepatocellular carcinoma in patients undergoing transplantation for liver cirrhosis Aim: To determine the effectiveness of MDCT in the diagnosis of hepatocellular carcinoma. Material and Methods: Thirty-seven patients who underwent liver transplantation and were evaluated with dynamic MDCT before the surgery were enrolled in the study. Two radiologists blinded to the pathological results retrospectively evaluated 64-channel dual or three phase dynamic MDCT images for the presence of hepatocellular carcinoma. The size, number and location of the lesions detected in each patient were recorded. Each lesion was graded from 1 to 5 for the presence of hepatocellular carcinoma: 1 corresponded to definitely no, 2 possibly no, 3 unclear, 4 possibly yes and 5 definitely yes. Category 4 and 5 lesions were considered as hepatocellular carcinoma. Findings from pathological examinations were compared with those from MDCT. The sensitivity, the specificity, and the positive and negative predictive values of MDCT in the detection of hepatocellular carcinoma were determined. Results: Of the 37 explanted livers, 20 (54.1%) did not have hepatocellular carcinoma, but 17 (45.9%) had 32 hepatocellular carcinomas. The sizes of the lesions ranged from 10 mm to 70 mm (mean 23.5 mm). The sensitivity, the specificity, and the positive and negative predictive values of MDCT in the detection of hepatocellular carcinoma were found to be 82%-88%, 90%-95%, 87%-93% and 85%-90% respectively according to a patient-based evaluation and 78%-84%, 66%-66%, 71%-73% and 73%-79% respectively according to a lesion-based evaluation. Conclusion: The results of this study show that MDCT has acceptable sensitivity for the diagnosis of hepatocellular carcinoma. It can be used for imaging before transplantation. Key words: Liver, hepatocellular carcinoma, MDCT.