Diagnostic performance of triple-phase contrast-enhanced computed tomography and diffusion-weighted magnetic resonance imaging for evaluation of hepatocellular carcinoma

• Published in: Malaysian Journal of Medicine and Health Sciences
• Main Author: Mohamad Tarmizi N.H.; Shafiee F.S.; Mohamad N.S.; Mahmud M.H.
• Format: Article
• Language: English
• Published: Universiti Putra Malaysia Press 2021
• Online Access: https://www.scopus.com/inward/record.uri?eid=2-s2.0-85108976898&partnerID=40&md5=8d20293a155c26590d0887fc5c1c7eec

Introduction: Ultrasonography has a primary role in detecting hepatocellular carcinoma (HCC). However, contrast-enhanced Computed Tomography (CECT) and Diffusion Weighted Magnetic Resonance Imaging (DW-MRI) are advocated for further evaluation of HCC when patients with elevated HCC biomarker and new suspicious lesions are depicted in ultrasonography. This study is aimed to evaluate the diagnostic performance of triple-phase CECT and DW-MRI for the evaluation of HCC in patients with chronic liver disease. Methods: Radiological reports of patients (n=39) who had undergone triple-phase CECT and DW-MRI of liver for suspected HCC were reviewed. The reports were validated with serum alpha-fetoprotein (AFP) analysis. Both imaging sensitivity and specificity were determined using ROC curve. The Hounsfield Unit (HU) and apparent diffusion coefficient (ADC) cut-off values were estimated for discrimination between HCC and non-HCC lesions. Results: AFP results showed 19 benign and 20 malignant HCC lesions. 85% sensitivity, 95% specificity and 90% accuracy were observed in triple-phase CECT (AUC 0.90, p < 0.001) while similar sensitivity, specificity and accuracy of 95% were observed in DW-MRI (AUC 0.95, p < 0.001). 43.0, 50.5 and 46.0 HU cut-off were observed in arterial, portal venous and delayed phases CECT, respectively while ADC cut-offs of 1.2405 x 10-3mm2/s at b = 50 s/mm2 and 1.2475 x 10-3mm2/s at b= 1600 s/mm2 were observed in DW-MRI. Conclusion: DW-MRI demonstrated more superior diagnostic performance than triple-phase CECT for the evaluation of HCC. The present findings could potentially facilitate the clinical management for improved accurate diagnosis of HCC in patients with chronic liver disease. © 2021 UPM Press. All rights reserved.