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Diagnostic Value of Imaging Methods in the Histological Four Grading of Hepatocellular Carcinoma

Authors :
Feiqian Wang
Kazushi Numata
Masayuki Nakano
Mikiko Tanabe
Makoto Chuma
Hiromi Nihonmatsu
Akito Nozaki
Katsuaki Ogushi
Wen Luo
Litao Ruan
Masahiro Okada
Masako Otani
Yoshiaki Inayama
Shin Maeda
Source :
Diagnostics, Vol 10, Iss 5, p 321 (2020)
Publication Year :
2020
Publisher :
MDPI AG, 2020.

Abstract

We attempted to establish an ultrasound (US) imaging-diagnostic system for histopathological grades of differentiation of hepatocellular carcinoma (HCC). We conducted a retrospective study of histopathologically confirmed 200 HCCs, classified as early (45 lesions), well- (31 lesions), moderately (68 lesions) or poorly differentiated (diff.) (56 lesions) HCCs. We performed grayscale US to estimate the presence/absence of halo and mosaic signs, Sonazoid contrast-enhanced US (CEUS) to determine vascularity (hypo/iso/hyper) of lesion in arterial and portal phase (PP), and echogenicity of lesion in post-vascular phase (PVP). All findings were of significance for the diagnosis of some (but not all) histological grades (p < 0.001–0.05). Combined findings with a relatively high diagnostic efficacy for early, poorly and moderately diff. HCC were a combination of absence of halo sign and isoechogenicity in PVP of CEUS (accuracy: 93.0%, AUC: 0.908), hypovascularity in PP (accuracy: 78.0%, area under the curve (AUC): 0.750), and a combination of isovascularity in PP and hypoechogenicity in PVP (accuracy: 75.0%, AUC: 0.739), respectively. On the other hand, neither any individual finding nor any combination of findings yielded an AUC of over 0.657 for the diagnosis of well-diff. HCC. Our study provides encouraging data on Sonazoid CEUS in the histological differential diagnosis of HCC, especially in early HCC, and the effectiveness of this imaging method should be further proved by prospective, large sample, multicenter studies.

Details

Language :
English
ISSN :
20754418 and 93814348
Volume :
10
Issue :
5
Database :
Directory of Open Access Journals
Journal :
Diagnostics
Publication Type :
Academic Journal
Accession number :
edsdoj.7f9feb78e5ed44ad938143481a749971
Document Type :
article
Full Text :
https://doi.org/10.3390/diagnostics10050321