Multidetector ct in detection of hepatocellular carcinoma meeting the milan criteria before liver transplantation

Background: Liver transplantation has been considered to be the only causal treatment for patients with liver cirrhosis and hepatocellular carcinoma (HCC) due to its theoretical advantage of eliminating both the tumor and liver disease. However, because of the shortage of donor organs, it is strongly recommended that liver transplantations should be performed on cirrhotic patients with HCCs only when the patients meet the predetermined criteria. Imaging is thus decisive in the patient inclusion or exclusion from transplantation lists. Objective: The purpose of this study was to assess the diagnostic performance of MDCT in the detection of hepatocellular carcinoma in cirrhotic patients who are recommended for liver transplantation according to the Milan criteria. Methods: This study included 35 patients (29 males and 6 females) with their age ranged from 39 years to 60 years old, presented to the transplantation unit of the National Liver Institute, Menoufia University in the period between May 2013 and December 2014. Potential recipients with focal lesion on their ultrasound underwent Triphasic CT and after liver transplantation the imaging findings were correlated with histopathological findings in the explanted livers on a patient-by-patient and a lesion-by-lesion basis. Results: Histopathologic examination revealed 46 hepatocellular carcinomas in 31of 35 patients while MDCT revealed 42 hepatocellular carcinomas in 30 of 35 patients. Patient-by-patient analysis showed that the sensitivity of MDCT in detection of HCC was 90.3 %, its specificity was 50 % & its accuracy was 85.7%. Conclusion: Multidetector CT (MDCT) has reasonable sensitivity and high diagnostic accuracy in the detection of hepatocellular carcinoma in patients with cirrhosis who will undergo liver transplantation according to the Milan criteria