Diagnosis and screening of small hepatocellular carcinomas. Comparison of radionuclide imaging, ultrasound, computed tomography, hepatic angiography, and alpha 1-fetoprotein assay.
Twenty-nine small (less than 5 cm) hepatocellular carcinomas in 18 patients were examined by radionuclide imaging (RN), ultrasound (US), computed tomography (CT), hepatic angiography, and serum alpha 1-fetoprotein (AFP) assay. Sensitivity was 39% with RN, 50% with US, 56% with CT, and 94% with angiography, including infusion hepatic angiography (IHA). Lesions larger than 3 cm could be detected by all of these methods; those between 2 and 3 cm were generally shown by US and CT but not RN. IHA was essential for diagnosis of lesions less than 2 cm, which were otherwise difficult or impossible to detect except with angiography. As a screening method, AFP was best, followed by US and CT. The authors recommend using AFP and US to minimize expense and radiation exposure. In questionable cases, IHA should be performed.
D000328:Adult; D000368:Aged; D000792:Angiography; D006528:Carcinoma, Hepatocellular / Q000175:diagnosis*; D003974:Diatrizoate Meglumine; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013455:Sulfur; D013667:Technetium; D013671:Technetium Tc 99m Sulfur Colloid; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography; D000509:alpha-Fetoproteins / Q000032:analysis
D000509:alpha-Fetoproteins; D003974:Diatrizoate Meglumine; D013671:Technetium Tc 99m Sulfur Colloid; D013455:Sulfur; D013667:Technetium