Sensitivity of ultrasound in detecting hepatocellular carcinoma in obese patients compared to explant pathology as the gold standard
Background/Aims The American Association for the Study of Liver Diseases recommends ultrasound (US) screening for hepatocellular carcinoma (HCC) among cirrhotic patients, regardless of body mass index (BMI), every 6 months. We examined US sensitivity for diagnosis of HCC in obese patients. Methods L...
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| Format: | Article |
| Language: | English |
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Korean Association for the Study of the Liver
2020-01-01
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| Series: | Clinical and Molecular Hepatology |
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| Online Access: | http://e-cmh.org/upload/pdf/cmh-2019-0039.pdf |
| _version_ | 1818142321530634240 |
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| author | Jamak Modaresi Esfeh Kaveh Hajifathalian Kianoush Ansari-Gilani |
| author_facet | Jamak Modaresi Esfeh Kaveh Hajifathalian Kianoush Ansari-Gilani |
| author_sort | Jamak Modaresi Esfeh |
| collection | DOAJ |
| description | Background/Aims The American Association for the Study of Liver Diseases recommends ultrasound (US) screening for hepatocellular carcinoma (HCC) among cirrhotic patients, regardless of body mass index (BMI), every 6 months. We examined US sensitivity for diagnosis of HCC in obese patients. Methods Liver transplant patients data with HCC in explant was used (January 2012-December 2017). All patients underwent liver US within 3 months of diagnosis of HCC. Number/size of HCC lesions were extracted from radiologic and pathologic reports. Obesity was defined as BMI ≥30 kg/m2. Results One hundred sixteen patients were included. 80% were male, with mean BMI of 31 kg/m2. The most common underlying liver disease was hepatitis C virus (62%). At the time of diagnosis, median number of HCC lesions was 2 (interquartile range [IQR], 1–3), and median size of the largest lesion was 2.5 cm (IQR, 1.75–3.9). Overall sensitivity of US study for detection of HCC was 33% (95% confidence interval [CI], 29–48%). Sensitivity was 77% (95% CI, 62–93%) in patients with BMI<30 and 21% (95% CI, 11–30%) in patients with BMI≥30 (P<0.001). Size of the largest HCC lesion (P=0.290) and number of lesions (P=0.505) were not different between groups. Computed tomography (CT) scan detected HCC in 98% of the obese patients with negative US. Conclusions Sensitivity of US for detection of HCC is significantly lower among obese patients compared to overweight and normal weight patients. These patients may benefit from alternating between US and a different imaging modality. |
| first_indexed | 2024-12-11T11:13:55Z |
| format | Article |
| id | doaj.art-badd271f972040909490e59fcac26cd9 |
| institution | Directory Open Access Journal |
| issn | 2287-2728 2287-285X |
| language | English |
| last_indexed | 2024-12-11T11:13:55Z |
| publishDate | 2020-01-01 |
| publisher | Korean Association for the Study of the Liver |
| record_format | Article |
| series | Clinical and Molecular Hepatology |
| spelling | doaj.art-badd271f972040909490e59fcac26cd92022-12-22T01:09:25ZengKorean Association for the Study of the LiverClinical and Molecular Hepatology2287-27282287-285X2020-01-01261545910.3350/cmh.2019.00391487Sensitivity of ultrasound in detecting hepatocellular carcinoma in obese patients compared to explant pathology as the gold standardJamak Modaresi Esfeh0Kaveh Hajifathalian1Kianoush Ansari-Gilani2 Department of Gastroenterology and Transplant Hepatology, Cleveland Clinic, Cleveland, OH, USA Department of Gastroenterology and Transplant Hepatology, Weill Cornell Medicine, New York, NY, USA Department of Radiology, University Hospitals Cleveland Medical Center, Cleveland, OH, USABackground/Aims The American Association for the Study of Liver Diseases recommends ultrasound (US) screening for hepatocellular carcinoma (HCC) among cirrhotic patients, regardless of body mass index (BMI), every 6 months. We examined US sensitivity for diagnosis of HCC in obese patients. Methods Liver transplant patients data with HCC in explant was used (January 2012-December 2017). All patients underwent liver US within 3 months of diagnosis of HCC. Number/size of HCC lesions were extracted from radiologic and pathologic reports. Obesity was defined as BMI ≥30 kg/m2. Results One hundred sixteen patients were included. 80% were male, with mean BMI of 31 kg/m2. The most common underlying liver disease was hepatitis C virus (62%). At the time of diagnosis, median number of HCC lesions was 2 (interquartile range [IQR], 1–3), and median size of the largest lesion was 2.5 cm (IQR, 1.75–3.9). Overall sensitivity of US study for detection of HCC was 33% (95% confidence interval [CI], 29–48%). Sensitivity was 77% (95% CI, 62–93%) in patients with BMI<30 and 21% (95% CI, 11–30%) in patients with BMI≥30 (P<0.001). Size of the largest HCC lesion (P=0.290) and number of lesions (P=0.505) were not different between groups. Computed tomography (CT) scan detected HCC in 98% of the obese patients with negative US. Conclusions Sensitivity of US for detection of HCC is significantly lower among obese patients compared to overweight and normal weight patients. These patients may benefit from alternating between US and a different imaging modality.http://e-cmh.org/upload/pdf/cmh-2019-0039.pdfliver cirrhosisneoplasmsobesity |
| spellingShingle | Jamak Modaresi Esfeh Kaveh Hajifathalian Kianoush Ansari-Gilani Sensitivity of ultrasound in detecting hepatocellular carcinoma in obese patients compared to explant pathology as the gold standard Clinical and Molecular Hepatology liver cirrhosis neoplasms obesity |
| title | Sensitivity of ultrasound in detecting hepatocellular carcinoma in obese patients compared to explant pathology as the gold standard |
| title_full | Sensitivity of ultrasound in detecting hepatocellular carcinoma in obese patients compared to explant pathology as the gold standard |
| title_fullStr | Sensitivity of ultrasound in detecting hepatocellular carcinoma in obese patients compared to explant pathology as the gold standard |
| title_full_unstemmed | Sensitivity of ultrasound in detecting hepatocellular carcinoma in obese patients compared to explant pathology as the gold standard |
| title_short | Sensitivity of ultrasound in detecting hepatocellular carcinoma in obese patients compared to explant pathology as the gold standard |
| title_sort | sensitivity of ultrasound in detecting hepatocellular carcinoma in obese patients compared to explant pathology as the gold standard |
| topic | liver cirrhosis neoplasms obesity |
| url | http://e-cmh.org/upload/pdf/cmh-2019-0039.pdf |
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