Transabdominal ultrasonographic evaluation of hepatocellular carcinoma and its correlation with cytopathological findings

Aims and Objectives: To compare the ultrasonographic findings of hepatocellular carcinoma (HCC) with that of cytopathology to asses the diagnostic validity of transabdominal ultrasonography (USG). Settings and Design: Cross-sectional study in Sir Salimullah Medical College and Mitford Hospital, Dhaka. Materials and Methods: This cross-sectional study was carried out in the department of radiology and imaging of Sir Salimullah Medical College and Mitford Hospital, Dhaka, during July, Dhaka, during July 2009–March 2011 to evaluate the transabdominal USG in the detection of HCC and its validity by determining sensitivity, specificity, accuracy, and positive and negative predictive values. For this purpose, a total of fifty patients were enrolled in the study. Cytopathology was done in all these patients. Statistical Analysis: Statistical analyses of the results were obtained using window-based computer software devised with Statistical Package for the Social Sciences (SPSS-13) (SPSS Inc., Chicago, IL, USA). The analysis of the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and diagnostic accuracy was done using online OpenEpi, Version 3, an open-source calculator. Results: The current study found that the mean age of patients was 49.14 ± 13.79 years, ranging from 20 to 79 years. The USG detected HCC in 31 (62%) cases, of which 27 (87.1%) were cytopathologically proven. USG diagnosed 19 (38%) cases as lesions other than HCC, of which 4 (21.1%) cases were diagnosed as HCC cytopathologically (false negative). The rest of the 15 (78.9%) cases were diagnosed as other lesions including metastasis, by both USG and cytopathologically (true negative). The validity of USG was studied by calculating sensitivity, specificity, accuracy, PPV, and NPV, which were 87.1%, 78.95%, 87.1%, 78.95%, and 84%, respectively. Conclusions: In this study, the USG findings and the validity tests were found almost identical as observed by other investigators compared with cytopathological findings. Hence, it can be concluded that the USG is a useful diagnostic modality in the diagnosis of HCC.