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Article Type

Original Study

Abstract

Objective: The purpose of this study was to assess the diagnostic performance of multidetector computed tomography (MDCT) in the detection of hepatocellular carcinoma (HCC) in cirrhotic patients who are recommended for liver transplantation according to the Milan criteria. Background: Liver transplantation has been considered to be the only causal treatment for patients with liver cirrhosis and HCC because of its theoretical advantage of eliminating both the tumor and liver disease. However, because of the shortage of donor organs, it is strongly recommended that liver transplantations be performed on cirrhotic patients with HCCs only when the patients meet the predetermined criteria. Imaging is thus decisive in the inclusion or exclusion of patients from transplantation lists. Patients and methods: This study included 35 patients (29 male and six female) with ages ranging from 39 to 60 years presented to the Transplantation Unit of the National Liver Institute, Menoufia University, during the period between May 2013 and December 2014. Potential recipients with focal lesion on their ultrasound underwent triphasic computed tomography. After liver transplantation, the imaging findings were correlated with histopathological findings in the explanted livers on a patient-by-patient and a lesion-by-lesion basis. Results Histopathologic examination revealed 46 HCCs in 31 of 35 patients, whereas MDCT revealed 42 HCCs in 30 of 35 patients. A patient-by-patient analysis showed that the sensitivity of MDCT in the detection of HCC was 90.3%, its specificity was 50%, and its accuracy was 85.7%. Conclusion: MDCT has reasonable sensitivity and high diagnostic accuracy in the detection of HCC in cirrhotic patients indicated for liver transplantation according to the Milan criteria.

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