A lexicon for hepatocellular carcinoma surveillance ultrasonography: benign versus malignant lesions

Clinical and Molecular Hepatology

Gulbahor Rakhmonova¹  Nieun Seo²  Chansik An²  Kyunghwa Han²  Jin Young Lee²  Myeong-Jin Kim²  Mi-Suk Park² 

[1] Department of Oncology and Radiology, Tashkent Medical Academy, Tashkent, Uzbekistan;Department of Radiology, Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul, Korea;

关键词: Carcinoma, Hepatocellular;    Surveillance;    Ultrasonography;   

DOI  :  10.3350/cmh.2016.0041

来源: DOAJ

【 摘 要 】

Background/Aims To suggest a lexicon for liver ultrasonography and to identify radiologic features indicative of benign or malignant lesions on surveillance ultrasonography. Methods This retrospective study included 188 nodules (benign, 101; malignant, 87) from 175 at-risk patients identified during surveillance ultrasonography for hepatocellular carcinoma. We created a lexicon for liver ultrasonography by reviewing relevant literature regarding the ultrasonographic features of hepatic lesions. Using this lexicon, two abdominal radiologists determined the presence or absence of each ultrasonographic feature for the included hepatic lesions. Independent factors associated with malignancy and interobserver agreement were determined by logistic regression analysis and kappa statistics, respectively. Results Larger tumor size (odds ratio [OR], 1.12; 95% confidence interval [CI], 1.06-1.183; P<0.001), multinodular confluent morphology (OR, 7.712; 95% CI, 1.053-56.465; P=0.044), thick hypoechoic rim (OR, 5.878; 95% CI, 2.681-12.888; P<0.001), and posterior acoustic enhancement (OR, 3.077; 95% CI, 1.237-7.655; P=0.016) were independently associated with malignant lesions. In a subgroup analysis of lesions <2 cm, none of the ultrasonographic features were significantly associated with malignancy or benignity. Interobserver agreement for morphology was fair (κ=0.36), while those for rim (κ=0.427), echogenicity (κ=0.549), and posterior acoustic enhancement (κ=0.543) were moderate. Conclusions For hepatic lesions larger than 2 cm, some ultrasonography (US) features might be suggestive of malignancy. We propose a lexicon that may be useful for surveillance US.

【 授权许可】

Unknown