A Comparison of Biannual Two-Phase Low-Dose Liver CT and US for HCC Surveillance in a Group at High Risk of HCC Development
Background and Aims: Biannual ultrasonography (US) is a current recommendation for hepatocellular carcinoma (HCC) surveillance in a high-risk group. The sensitivity of US, however, has been low in patients with a high risk of developing HCC. We aimed to compare sensitivity for HCC of biannual US and...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Karger Publishers
2020-08-01
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| Series: | Liver Cancer |
| Subjects: | |
| Online Access: | https://www.karger.com/Article/FullText/506834 |
| _version_ | 1818126574363344896 |
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| author | Jeong Hee Yoon Jeong Min Lee Dong Ho Lee Ijin Joo Ju Hyun Jeon Su Joa Ahn Seung-taek Kim Eun Ju Cho Jeong-Hoon Lee Su Jong Yu Yoon Jun Kim Jung-Hwan Yoon |
| author_facet | Jeong Hee Yoon Jeong Min Lee Dong Ho Lee Ijin Joo Ju Hyun Jeon Su Joa Ahn Seung-taek Kim Eun Ju Cho Jeong-Hoon Lee Su Jong Yu Yoon Jun Kim Jung-Hwan Yoon |
| author_sort | Jeong Hee Yoon |
| collection | DOAJ |
| description | Background and Aims: Biannual ultrasonography (US) is a current recommendation for hepatocellular carcinoma (HCC) surveillance in a high-risk group. The sensitivity of US, however, has been low in patients with a high risk of developing HCC. We aimed to compare sensitivity for HCC of biannual US and two-phase low-dose computed tomography (LDCT) in patients with a high risk of HCC. Methods: In this prospective single-arm study, participants with an annual risk of HCC greater than 5% (based on a risk index of ≥2.33) and who did not have a history of HCC were enrolled from November 2014 to July 2016. Participants underwent paired biannual US and two-phase LDCT 1–3 times. Two-phase LDCT included arterial and 3-min delayed phases. The sensitivity, specificity, and positive predictive value of HCC detection using US and two-phase LDCT were compared using a composite algorithm as a standard of reference. Results: Of the 139 enrolled participants, 137 underwent both the biannual US and two-phase LDCT at least once and had follow-up images. Among them, 27 cases of HCC (mean size: 14 ± 4 mm) developed in 24 participants over 1.5 years. Two-phase LDCT showed a significantly higher sensitivity (83.3% [20/24] vs. 29.2% [7/24], p < 0.001) and specificity (95.6% [108/113] vs. 87.7% [99/113], p =0.03) than US. A false-positive result was reported in 14 participants at US and 5 participants at two-phase LDCT, resulting in a significantly higher positive predictive value of two-phase LDCT (33.3% [7/21] vs. 80% [20/25], p < 0.001). Conclusions: Patients with a risk index ≥2.33 showed a high annual incidence of HCC development in our study, and two-phase LDCT showed significantly higher sensitivity and specificity for HCC detection than US. |
| first_indexed | 2024-12-11T07:03:37Z |
| format | Article |
| id | doaj.art-811d40fcdb674145be41f9ba1c5ffc88 |
| institution | Directory Open Access Journal |
| issn | 2235-1795 1664-5553 |
| language | English |
| last_indexed | 2024-12-11T07:03:37Z |
| publishDate | 2020-08-01 |
| publisher | Karger Publishers |
| record_format | Article |
| series | Liver Cancer |
| spelling | doaj.art-811d40fcdb674145be41f9ba1c5ffc882022-12-22T01:16:33ZengKarger PublishersLiver Cancer2235-17951664-55532020-08-0111510.1159/000506834506834A Comparison of Biannual Two-Phase Low-Dose Liver CT and US for HCC Surveillance in a Group at High Risk of HCC DevelopmentJeong Hee YoonJeong Min LeeDong Ho LeeIjin JooJu Hyun JeonSu Joa AhnSeung-taek KimEun Ju ChoJeong-Hoon LeeSu Jong YuYoon Jun KimJung-Hwan YoonBackground and Aims: Biannual ultrasonography (US) is a current recommendation for hepatocellular carcinoma (HCC) surveillance in a high-risk group. The sensitivity of US, however, has been low in patients with a high risk of developing HCC. We aimed to compare sensitivity for HCC of biannual US and two-phase low-dose computed tomography (LDCT) in patients with a high risk of HCC. Methods: In this prospective single-arm study, participants with an annual risk of HCC greater than 5% (based on a risk index of ≥2.33) and who did not have a history of HCC were enrolled from November 2014 to July 2016. Participants underwent paired biannual US and two-phase LDCT 1–3 times. Two-phase LDCT included arterial and 3-min delayed phases. The sensitivity, specificity, and positive predictive value of HCC detection using US and two-phase LDCT were compared using a composite algorithm as a standard of reference. Results: Of the 139 enrolled participants, 137 underwent both the biannual US and two-phase LDCT at least once and had follow-up images. Among them, 27 cases of HCC (mean size: 14 ± 4 mm) developed in 24 participants over 1.5 years. Two-phase LDCT showed a significantly higher sensitivity (83.3% [20/24] vs. 29.2% [7/24], p < 0.001) and specificity (95.6% [108/113] vs. 87.7% [99/113], p =0.03) than US. A false-positive result was reported in 14 participants at US and 5 participants at two-phase LDCT, resulting in a significantly higher positive predictive value of two-phase LDCT (33.3% [7/21] vs. 80% [20/25], p < 0.001). Conclusions: Patients with a risk index ≥2.33 showed a high annual incidence of HCC development in our study, and two-phase LDCT showed significantly higher sensitivity and specificity for HCC detection than US.https://www.karger.com/Article/FullText/506834hepatocellular carcinomasurveillanceultrasonographylow-dose ctcirrhosis |
| spellingShingle | Jeong Hee Yoon Jeong Min Lee Dong Ho Lee Ijin Joo Ju Hyun Jeon Su Joa Ahn Seung-taek Kim Eun Ju Cho Jeong-Hoon Lee Su Jong Yu Yoon Jun Kim Jung-Hwan Yoon A Comparison of Biannual Two-Phase Low-Dose Liver CT and US for HCC Surveillance in a Group at High Risk of HCC Development Liver Cancer hepatocellular carcinoma surveillance ultrasonography low-dose ct cirrhosis |
| title | A Comparison of Biannual Two-Phase Low-Dose Liver CT and US for HCC Surveillance in a Group at High Risk of HCC Development |
| title_full | A Comparison of Biannual Two-Phase Low-Dose Liver CT and US for HCC Surveillance in a Group at High Risk of HCC Development |
| title_fullStr | A Comparison of Biannual Two-Phase Low-Dose Liver CT and US for HCC Surveillance in a Group at High Risk of HCC Development |
| title_full_unstemmed | A Comparison of Biannual Two-Phase Low-Dose Liver CT and US for HCC Surveillance in a Group at High Risk of HCC Development |
| title_short | A Comparison of Biannual Two-Phase Low-Dose Liver CT and US for HCC Surveillance in a Group at High Risk of HCC Development |
| title_sort | comparison of biannual two phase low dose liver ct and us for hcc surveillance in a group at high risk of hcc development |
| topic | hepatocellular carcinoma surveillance ultrasonography low-dose ct cirrhosis |
| url | https://www.karger.com/Article/FullText/506834 |
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