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- Title
Contrast-enhanced US diagnostic algorithm of hepatocellular carcinoma in patients with occult hepatitis B.
- Authors
Huang, Yang; Li, Wei; Hu, Huang-Tong; Ruan, Si-Min; Xian, Meng-Fei; Xie, Xiao-Yan; Lu, Ming-De; Kuang, Ming; Chen, Li-Da; Wang, Wei
- Abstract
Purpose: To assess the diagnostic performance of contrast-enhanced (CE) US Liver Imaging Reporting and Data System (LI-RADS) version 2017 and propose a diagnostic algorithm in diagnosing hepatocellular carcinoma (HCC) in patients with occult HBV infection (OBI). Methods: 251 OBI patients with 251 newly diagnosed focal liver lesions were retrospectively enrolled. Each nodule was evaluated according to CEUS LI-RADS. The subgroup analyses were also performed in patients with alpha-fetoprotein (AFP) more than 20ug/L or not. Diagnostic performance of CEUS LI-RADS for diagnosing HCC was validated via sensitivity, specificity, accuracy, positive predictive value (PPV), and negative predictive value (NPV), respectively. Results: There were 90 HCCs (90 of 251, 35.9%), of which 2 (2.0%), 53 (53.5%), and 35 (35.4%) were classified as LR-4, LR-5, and LR-M, respectively. The sensitivity, specificity, accuracy, PPV, and NPV of CEUS LR-5 for HCC diagnosis were 58.9%, 88.8%, 78.1%, 74.6%, and 79.4%, respectively. AFP increased in 50.6% (45/89) HCCs. Using a proposed diagnostic algorithm (for OBI patients with AFP more than 20 ug/L, LR-5 nodules were diagnosed as definitely HCC), the sensitivity, specificity, accuracy, PPV, and NPV were 62.2%, 71.4%, 63.5%, 93.3%, and 22.7%, respectively. Therefore, 12.2% (30 of 246) nodules could be confirmed as HCC by CEUS without biopsy. Conclusion: HCC diagnosis in patients with OBI is challenging. However, using LR-5 as a noninvasively diagnostic standard in OBI patients with AFP more than 20ug/L, HCC could be confirmed by CEUS without biopsy.
- Subjects
HEPATITIS B; HEPATOCELLULAR carcinoma; HEPATITIS associated antigen; CHRONIC hepatitis B; OCCULTISM; ALPHA fetoproteins; ULTRASONIC imaging; PREDICTIVE tests; CONTRAST media; RETROSPECTIVE studies; SENSITIVITY &; specificity (Statistics); ALGORITHMS
- Publication
Abdominal Radiology, 2022, Vol 47, Issue 2, p608
- ISSN
2366-004X
- Publication type
Article
- DOI
10.1007/s00261-021-03343-x