Size of the Hepatic Lesions as an Additional Radiological Feature to Differentiate Hepatocellular Carcinoma from Liver Metastasis

Export Objective: Hepatocellular carcinoma (HCC) is a unique malignancy that presents a diagnostic challenge due to its ability to be diagnosed based on radiological and biochemical features without the need for a biopsy. However, distinguishing HCC from liver metastasis, particularly in cases of solitary liver lesions, can be challenging. Therefore, the objective of this study was to assess the diagnostic value of hepatic lesion size in differentiating between HCC and liver metastasis. Methods: From August 2006 to September 2010, we conducted a retrospective analysis of a collected database that included 13 different radiologic features. The study included patients diagnosed at the Northwest Armed Forces Hospital in Tabuk, Saudi Arabia, who had confirmed cases of hepatocellular carcinoma (HCC) or liver metastasis with a known origin. Results: Thirty-three (37.1%) patients had HCC and 56 (62.9%) had liver metastasis. In addition to the presence of classical enhancement, satellite nodules, necrosis, ascites, central lesions, and vascular invasion, the size of hepatic lesion more than 53mm was an important, novel radiological feature supporting the diagnosis of HCC (P=0.0001). The sensitivity and specificity of the optimal cutoff level (53mm) determined by the applying receiver operating characteristic curve were 75% and 89.7%, respectively. Conclusions: In the absence of early detection, the size of the hepatic lesion as an additional radiological feature can play a role in differentiation between HCC and liver metastasis.