title: The role of laparoscopic US and laparoscopic US-guided aspiration biopsy in the diagnosis of multicentric hepatocellular carcinoma.
abstract: BACKGROUND
  Detection of small hepatocellular carcinomas has become possible with improvements in various diagnostic imaging techniques. However, intraoperative US can detect lesions not visualized by any preoperative imaging study in which case it is difficult to determine whether the lesion is a hepatocellular carcinoma.
  
  
  METHODS
  Nodular lesions detected by laparoscopic US in 186 patients with hepatocellular carcinoma were examined and we evaluated the diagnostic ability of laparoscopic US to detect multicentric hepatocellular carcinoma.
  
  
  RESULTS
  One hundred thirty-four new nodular lesions were detected by laparoscopic US in 64 (34.4%) of 186 patients. Aspiration biopsy under laparoscopic US guidance was performed on the 134 nodules, and 28 nodules in 23 (12.4%) of the 186 patients were histologically diagnosed as hepatocellular carcinoma. Of these 23 patients, 18 had been diagnosed with solitary hepatocellular carcinoma before laparoscopic US. One hundred six of the newly detected lesions were initially diagnosed as noncarcinomatous nodules, but the diagnosis of 10 of these lesions was changed to hepatocellular carcinoma during follow-up that was as long as 96 months.
  
  
  CONCLUSIONS
  Laparoscopic US is useful in the initial diagnosis of hepatocellular carcinoma and impacts treatment selection by more accurately defining the presence of multicentric hepatocellular carcinomas.
authors.affiliation: Department of Gastroenterology, Jichi Medical School, Yakushiji, Tochigi, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Ido
authors.forename: Y
authors.initials: Y
authors.lastname: Nakazawa
authors.forename: N
authors.initials: N
authors.lastname: Isoda
authors.forename: C
authors.initials: C
authors.lastname: Kawamoto
authors.forename: N
authors.initials: N
authors.lastname: Nagamine
authors.forename: K
authors.initials: K
authors.lastname: Ono
authors.forename: M
authors.initials: M
authors.lastname: Hozumi
authors.forename: Y
authors.initials: Y
authors.lastname: Sato
authors.forename: K
authors.initials: K
authors.lastname: Kimura
authors.forename: K
authors.initials: K
authors.lastname: Sugano
mesh_terms: D001707:Biopsy, Needle; D006528:Carcinoma, Hepatocellular / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000628:therapy; D019160:Endosonography; D006801:Humans; D010535:Laparoscopy; D008113:Liver Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000628:therapy; D018084:Ultrasonography, Interventional