title: Accuracy of hepatocellular carcinoma detection on multidetector CT in a transplant liver population with explant liver correlation.
abstract: OBJECTIVE
  To evaluate the diagnostic accuracy of multidetector computed tomography (MDCT) for hepatocellular carcinoma (HCC) in cirrhotic patients undergoing liver transplantation. Secondary aims were to examine the effect of radiologist experience and lesion size on diagnostic accuracy.
  
  
  METHODS
  Thirty-nine patients (72% male with a mean age of 56.5 years) underwent liver transplantation following preoperative triple-phase MDCT examination of the liver. MDCT examinations were retrospectively independently reviewed by three radiologists for the presence and location of suspected HCCs, with the diagnostic confidence recorded using a five-point confidence scale. MDCT examinations were compared with explant specimens for histopathological correlation.
  
  
  RESULTS
  Histopathological results demonstrated 46 HCCs in 29 of the 39 patients. Analysis demonstrated a sensitivity of 65-75% and specificity of 47-88% for detection of HCC lesions. The sensitivity dropped to 48-57% for lesions of size ≤20mm. As the diagnostic confidence increased, there was a further decrease in the sensitivity (4-26%). The radiologist with the greatest number of years experience was found to have a significantly higher accuracy of detection of HCC lesions compared with the least experienced radiologist.
  
  
  CONCLUSIONS
  Larger lesion size of HCC and greater number of years experience of the radiologist resulted in significantly higher accuracy of HCC lesion detection. The overall sensitivity and specificity results for MDCT detection of HCC are comparable to previous helical CT imaging.
authors.affiliation: Department of Radiology, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK. helenclareaddley@hotmail.co.uk
authors.forename: H C
authors.initials: HC
authors.lastname: Addley
authors.forename: N
authors.initials: N
authors.lastname: Griffin
authors.forename: A S
authors.initials: AS
authors.lastname: Shaw
authors.forename: L
authors.initials: L
authors.lastname: Mannelli
authors.forename: R A
authors.initials: RA
authors.lastname: Parker
authors.forename: S
authors.initials: S
authors.lastname: Aitken
authors.forename: H
authors.initials: H
authors.lastname: Wood
authors.forename: S
authors.initials: S
authors.lastname: Davies
authors.forename: G J
authors.initials: GJ
authors.lastname: Alexander
authors.forename: D J
authors.initials: DJ
authors.lastname: Lomas
mesh_terms: D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging* / Q000473:pathology; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D016031:Liver Transplantation / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods*; D047368:Tumor Burden