Diagnosis of hepatoma using grayscale and Doppler ultrasound in patients with chronic liver disease

OBJECTIVE: To determine the diagnostic accuracy of liver ultrasound for the detection of hepatoma in chronic liver disease (CLD) patients by either taking histopathology or serum α-fetoprotein levels or a biphasic computed tomography (CT) scan (whichever is available) as the gold standard. STUDY DESIGN: Cross-sectional. PLACE AND DURATION OF STUDY: Radiology Department, The Aga Khan University Hospital, Karachi, Pakistan, from January 2007 to January 2010. METHODS: A total of 239 patients (156 males and 83 females) with clinical suspicion or surveillance of hepatoma in CLD referred to the radiology department for ultrasound evaluation followed by either liver biopsy and histopathology or serum α-fetoprotein level or biphasic CT scan. RESULTS: The sensitivity of ultrasound for hepatoma detection in CLD was 65%, specificity was 85%, and accuracy was 70%, and positive predictive value and negative predictive value were 92% and 45%, respectively. CONCLUSION: Ultrasound is a relatively quick, safe, reasonably accurate, and noninvasive imaging modality for the detection of hepatoma in CLD and can be complemented with clinical assessment of screening high-risk patients.