Triple Phase Multidetector Computed Tomography of Hepatic Masses with Cytopathological Correlation

Abstract

Introduction: Lesions of the liver may be benign or malignant and they can arise from hepatocytes, biliary epithelium, mesenchymal tissue or metastases from extra hepatic tissue. Along with Ultrasonography (USG), triple phase Multidetector Computed Tomography (MDCT) scan is a good non-invasive tool in characterising and differentiating benign from malignant liver lesions. Aim: To characterise various hepatic masses with the help of triple phase MDCT scan and to correlate them with histopathological/ cytopathological findings. Materials and Methods: By convenient sampling, in this observational study, 55 patients with primary diagnosis of hepatic masses on the basis of USG, were recruited and their triphasic MDCT scan findings were evaluated and later correlated with histopathology. SPSS version 22 and electronic Microsoft Excel spreadsheets were used. Categorical data has been represented as frequency (number) and proportions (percentages), continuous data as Mean±Standard Deviation (SD). ANOVA and Chi-square tests were used. Agreement between different diagnostic modalities was made using Kappa-statistic. The confidence level was kept at 95%, hence a p-value <0.05 was considered as statistically significant. Results: Among 55 patients, 4 (7.27%) were benign and 51 (92.73%) were malignant cases detected with the help of USG and same was verified on the basis of triphasic CT assessment. On histopathology, 50 (90.91%) were identified as malignant lesion while 5 (9.09%) cases were diagnosed benign lesions. Thus, triphasic CT scan has a sensitivity of 100%, specificity of 80%, Positive Predictive Value (PPV) of 98.04%, Negative Predictive Value (NPV) of 100% and diagnostic accuracy of 98.18% in differentiating benign liver lesions from malignant liver lesions. Conclusion: Early and accurate diagnosis of liver lesions is the foremost requirement in treatment. Triple phase MDCT scan along with USG can solve this and recommended in every suspected hepatic mass.

Keywords

• histocytopathology
• liver mass
• liver secondaries
• ultrasonography