Diagnostic Accuracy of Ultrasonography and CT-Scan in Detecting Hepatocellular Carcinoma (HCC)

Introduction: Hepatocellular carcinoma (HCC) is a leading cause of cancer-related mortality globally and its early detection plays a vital role in improving patient prognosis and treatment outcomes. Ultrasonography (US) and computed tomography (CT) are key diagnostic tools. While US is cost-effective and widely accessible, CT offers superior sensitivity for detecting small lesions and assessing tumor extent. Aim of the study: The aim of the study was to evaluate the diagnostic accuracy of ultrasonography (US) and computed tomography (CT) in detecting hepatocellular carcinoma (HCC). Methods: This cross-sectional study, conducted from June 2007 to May 2008 at BIRDEM, BSMMU, and Gastro liver Hospital in Dhaka, included 30 patients (26 male, 4 females, aged 20-85 years) with clinically suspected hepatocellular carcinoma (HCC). Patients underwent clinical assessment, ultrasound (US), and CT scans for tumor evaluation. The final HCC diagnosis was confirmed by biopsy and histopathology. Sensitivity, accuracy, and predictive values of US and CT were analyzed using SPSS, with a significance level of p < 0.05. Results: In this study of 30 patients, the mean age was 50.89 years, with the most common age group being 31-40 years (29.9%). The majority were male (86.7%). Hepatomegaly (83.3%), upper abdominal pain (66.7%), and weight loss (60%) were the most common clinical features. Biochemical results showed that 33.3% of patients were HBs Ag positive, and 70% had elevated alpha-fetoprotein (AFP). Imaging revealed liver enlargement in 66.7% (USG) and 77.3% (CT) of cases, with CT detecting more multifocal lesions (43.3% vs. 16.7% on USG, p<0.05). The combined sensitivity of USG and CT for diagnosing hepatocellular carcinoma (HCC) was 96%, with an accuracy of 83.3%, but specificity was low at 20%. Conclusion: Ultrasound (USG) and CT are effective for diagnosing hepatocellular carcinoma (HCC) with high sensitivity but low specificity. Combining both improves diagnostic precision, ..