| Abstrakt: |
Introduction: HCC is the dominant primary liver cancer, representing the fourth cancer related mortality. Surgery is the main curative treatment by either resection or transplantation which is the choice to deal with the underlying liver disease together with the tumor, making it the attractive option in cirrhotic patients. However accepted survival could only be achieved by careful patient selection. Pre-treatment assessment with CT and MRI is the corner stone in staging and selection to achieve the desired outcome, so tumor characteristics should be evaluated accurately to guide with the other factors the treatment strategy for those patients. Materials & Methods: A total of 77 HCC patients who had DDLT in Liver unit at Queen Elizabeth Hospital, University of Birmingham NHS Trust, Birmingham, UK were retrospectively and prospectively evaluated by chart review. Five parameters chosen to assess the accuracy of preoperative Radiological Staging methods; CT, MRI, in comparison with their explanted liver histopathological results. These parameters were: (1) Number of nodules, (2) Total tumor size, (3) Vascular invasion, (4) Diameter of the largest nodule and (5) Tumor multi-nodularity Results: Pathologically assessed post-operative nodular number (2.12 ± 1.24) and total tumor sizes (4.75±2.22 cm.) were significantly higher than pre-operative radiological tumors number (1.64 ± 1.10) and total tumors sizes (4.08 ± 2.41) (P <0.005, P <0.051, respectively). Radiological imaging were of the least sensitivity in detecting vascular invasion (sensitivity was 4.17%) while it is most accurate in determining the diameter of the largest tumor as well as the tumor multi-nodularity (sensitivity 45.24%) Conclusions: small sub-centimeter HCC might be missed on 5–10 mm sectioning, potentially accounting for some of the supposed false-positive findings of CT and MRI. Also, the imaging pathology correlation might have been improved with less false positives if the pathologists had been prospectively informed of detailed imaging findings. [ABSTRACT FROM AUTHOR] |
