COMPARISON OF IMAGE FINDINGS WITH HISTOPATHOLOGICAL DIAGNOSIS ON ULTRASOUND GUIDED PERCUTANEOUS LIVER BIOPSY IN RELATION TO HEPATOCELLULAR CARCINOMA

Abstract

OBJECTIVES: To compare the image findings with histopathological diagnosis on ultrasound guided (USG) percutaneous biopsies of liver lesions in relation to hepatocellular carcinoma (HCC) and to assess the role of hepatitis B virus (HBV) and hepatitis C virus (HCV) in evolution of HCC. METHODS: This descriptive cross-sectional study included biopsies performed on patients reporting to Kuwait Teaching Hospital, Peshawar, Pakistan from 01-07-2017 to 30-09-2017. The patient selection was based on findings on various image modalities like triphasic liver computed tomography (CT) or dynamic magnetic resonance imaging (MRI), in which percutaneous liver biopsy was indicated. The biopsies were routinely processed for histological examination on hematoxyllin and eosin stain and application of immunohistochemical stains for detecting HCC. RESULTS: A total number of 82 USG percutaneous biopsies were performed on various sites out of which 41 (50%) were performed on liver lesions. On imaging 12 (30%) were diagnosed as hepatocellular carcinoma whereas 16 (39%) cases were confirmed on histopathology, which either showed Hep-Par-1 or arginase positivity. On imaging 11/16 (68.75%) were either diagnosed as HCC or were suspicious of it. A sensitivity of 75% and specificity of 95% was calculated for diagnosis of HCC on imaging. The correlation between image and biopsy diagnosis of HCC was statistically significant (p value 0.05). CONCLUSION: The present study concludes that Image findings are helpful in the initial diagnosis of HCC which shows an increasing trend to be associated HCV as compared to HBV with a remarkably declining trend.

Keywords

• Image-Guided Biopsy
• Ultrasonography
• Liver
• Hepatocellular Carcinoma
• Hepacivirus
• Hepatitis B virus
• Immunohistochemistry