Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Feb;47(2):608-617.
doi: 10.1007/s00261-021-03343-x. Epub 2021 Nov 20.

Contrast-enhanced US diagnostic algorithm of hepatocellular carcinoma in patients with occult hepatitis B

Yang Huang  1 , Wei Li  1 , Huang-Tong Hu  1 , Si-Min Ruan  1 , Meng-Fei Xian  1 , Xiao-Yan Xie  1 , Ming-De Lu  1   2 , Ming Kuang  1   2 , Li-Da Chen  3 , Wei Wang  4
Affiliations

Contrast-enhanced US diagnostic algorithm of hepatocellular carcinoma in patients with occult hepatitis B

Yang Huang et al. Abdom Radiol (NY). 2022 Feb.

Abstract

Purpose: To assess the diagnostic performance of contrast-enhanced (CE) US Liver Imaging Reporting and Data System (LI-RADS) version 2017 and propose a diagnostic algorithm in diagnosing hepatocellular carcinoma (HCC) in patients with occult HBV infection (OBI).

Methods: 251 OBI patients with 251 newly diagnosed focal liver lesions were retrospectively enrolled. Each nodule was evaluated according to CEUS LI-RADS. The subgroup analyses were also performed in patients with alpha-fetoprotein (AFP) more than 20ug/L or not. Diagnostic performance of CEUS LI-RADS for diagnosing HCC was validated via sensitivity, specificity, accuracy, positive predictive value (PPV), and negative predictive value (NPV), respectively.

Results: There were 90 HCCs (90 of 251, 35.9%), of which 2 (2.0%), 53 (53.5%), and 35 (35.4%) were classified as LR-4, LR-5, and LR-M, respectively. The sensitivity, specificity, accuracy, PPV, and NPV of CEUS LR-5 for HCC diagnosis were 58.9%, 88.8%, 78.1%, 74.6%, and 79.4%, respectively. AFP increased in 50.6% (45/89) HCCs. Using a proposed diagnostic algorithm (for OBI patients with AFP more than 20 ug/L, LR-5 nodules were diagnosed as definitely HCC), the sensitivity, specificity, accuracy, PPV, and NPV were 62.2%, 71.4%, 63.5%, 93.3%, and 22.7%, respectively. Therefore, 12.2% (30 of 246) nodules could be confirmed as HCC by CEUS without biopsy.

Conclusion: HCC diagnosis in patients with OBI is challenging. However, using LR-5 as a noninvasively diagnostic standard in OBI patients with AFP more than 20ug/L, HCC could be confirmed by CEUS without biopsy.

Keywords: Alpha-fetoprotein; Contrast-enhanced US; Diagnostic techniques and procedures; Hepatitis B surface antigens; Hepatocellular carcinoma.

PubMed Disclaimer

References

    1. European Association for the Study of the Liver. Electronic address eee, European Association for the Study of the L (2018) EASL Clinical Practice Guidelines: Management of hepatocellular carcinoma. Journal of hepatology 69(1):182-236. - DOI
    1. Bosetti C, Levi F, Boffetta P, et al. (2008) Trends in mortality from hepatocellular carcinoma in Europe, 1980–2004. Hepatology (Baltimore, Md.) 48(1):137–145.
    1. Raimondo G, Locarnini S, Pollicino T, et al. (2019) Update of the statements on biology and clinical impact of occult hepatitis B virus infection. Journal of Hepatology 71(2):397-408. - DOI
    1. European Association for the Study of the Liver. Electronic address eee, European Association for the Study of the L (2017) EASL 2017 Clinical Practice Guidelines on the management of hepatitis B virus infection. Journal of hepatology 67(2):370-398. - DOI
    1. Marrero JA, Kulik LM, Sirlin CB, et al. (2018) Diagnosis, Staging, and Management of Hepatocellular Carcinoma: 2018 Practice Guidance by the American Association for the Study of Liver Diseases. Hepatology 68(2):723-750. - DOI

Publication types

MeSH terms

LinkOut - more resources