COMPARISON OF IMAGE FINDINGS WITH HISTOPATHOLOGICAL DIAGNOSIS ON ULTRASOUND GUIDED PERCUTANEOUS LIVER BIOPSY IN RELATION TO HEPATOCELLULAR CARCINOMA

Main Article Content

Abdul Majid
Muhammad Mumtaz Khan
Abdul Aziz Zia
Sadaf Alam

Abstract

ABSTRACT

OBJECTIVES: To compare the image findings with histopathological diagnosis on ultrasound guided (USG) percutaneous biopsies of liver lesions in relation to hepatocellular carcinoma (HCC) and to assess the role of hepatitis B virus (HBV) and hepatitis C virus (HCV) in evolution of HCC.

METHODS: This descriptive cross-sectional study included biopsies performed on patients reporting to Kuwait Teaching Hospital, Peshawar, Pakistan from 01-07-2017 to 30-09-2017. The patient selection was based on findings on various image modalities like triphasic liver computed tomography (CT) or dynamic magnetic resonance imaging (MRI), in which percutaneous liver biopsy was indicated. The biopsies were routinely processed for histological examination on hematoxyllin and eosin stain and application of immunohistochemical stains for detecting HCC.

RESULTS: A total number of 82 USG percutaneous biopsies were performed on various sites out of which 41 (50%) were performed on liver lesions. On imaging 12 (30%) were diagnosed as hepatocellular carcinoma whereas 16 (39%) cases were confirmed on histopathology, which either showed Hep-Par-1 or arginase positivity. On imaging 11/16 (68.75%) were either diagnosed as HCC or were suspicious of it. A sensitivity of 75% and specificity of 95% was calculated for diagnosis of HCC on imaging. The correlation between image and biopsy diagnosis of HCC was statistically significant (p value 0.05).

CONCLUSION: The present study concludes that Image findings are helpful in the initial diagnosis of HCC which shows an increasing trend to be associated HCV as compared to HBV with a remarkably declining trend.

KEY WORDS: Image-Guided Biopsy (MeSH); Ultrasonography (MeSH); Liver (MeSH); Carcinoma, Hepatocellular (MeSH); Hepacivirus (MeSH); Hepatitis B virus (MeSH); Immunohistochemistry (MeSH); Histology (MeSH).

Article Details

How to Cite
Majid, Abdul, et al. “COMPARISON OF IMAGE FINDINGS WITH HISTOPATHOLOGICAL DIAGNOSIS ON ULTRASOUND GUIDED PERCUTANEOUS LIVER BIOPSY IN RELATION TO HEPATOCELLULAR CARCINOMA”. KHYBER MEDICAL UNIVERSITY JOURNAL, vol. 10, no. 4, Dec. 2018, pp. 192-95, doi:10.35845/kmuj.2018.18102.
Section
Original Articles
Author Biographies

Abdul Majid, Department of Radiology, Kuwait Teaching Hospital, Peshawar affiliated with Riphah International University, Islamabad, Pakistan

Associate Professor

Department of Radiology

Muhammad Mumtaz Khan, Department of Pathology, Peshawar Medical College, Peshawar affiliated with Riphah International University, Islamabad, Pakistan.

Professor

Pathology Department

Abdul Aziz Zia, Department of Radiology, Kuwait Teaching Hospital, Peshawar affiliated with Riphah International University, Islamabad, Pakistan

Assistant Professor

Department of Radiology

Sadaf Alam, Department of Pathology, Peshawar Medical College, Peshawar affiliated with Riphah International University, Islamabad, Pakistan.

Assistant Professor

Department of Pathology

References

REFERENCES

El-Shabrawi MH El-Karaksy HM Okahsa SH Kamal NM El-Batran G Badr KA. Outpatient blind percutaneous liver biopsy in infants and children: is it safe? Saudi J Gastroenterol 2012 Jan-Feb;18(1):26-33. DOI: 10.4103/1319-3767.91735.

Menghini G. One-second needle biopsy of the liver. Gastroenterology 1958; 35(2): 190-9.

Vijayaraghavan GR, David S, Bermudez-Allende M, Sarwat H. Imaging-guided Parenchymal Liver Biopsy: How We Do It. J Clin Imaging Sci 2011;1:30. DOI: 10.4103/2156-7514.82082.

Shaheen AA, Wan AF, Myers RP. FibroTest and FibroScan for the prediction of hepatitis C-related fibrosis: a systematic review of diagnostic test accuracy. Am J Gastroenterol 2007 Nov;102(11):2589-600. DOI:10.1111/j.1572-0241.2007.01466.x

Piscaglia F, Salvatore V, Mulazzani L, Cantisani V, Schiavone C. Ultrasound Shear Wave Elastography for Liver Disease. A Critical Appraisal of the Many Actorson the Stage. Ultraschall Med 2016 Feb;37(1):1-5. DOI: 10.1055/s-0035-1567037.

Alswat KA, Mumtaz K, Jafri W. Liver biopsy for histological assessment: The case in favor. Saudi J Gastroenterol 2010 Apr-Jun;16(2):133-9. DOI: 10.4103/1319-3767.61245.

Rockey DC, Caldwell SH, Goodman ZD, Nelson RC, Smith AD; American Association for the Study of Liver Diseases. Liver Biopsy. Hepatology 2009 Mar;49(3):1017-44. DOI: 10.1002/hep.22742.

Iqbal J, Sattar A, Al-Qamari N, Hussain M, Rashid S. Compare the efficacy and complications of 16 gauge vs 18 gauge core biopsy needle in ultrasound guided percutaneous liver biopsies. J Dow Univ Healt Sci 2017;11(2):41-5.

McGlynn KA, Petrick JL, London WT. Global epidemiology of hepatocellular carcinoma: an emphasis on demographic and regional variability. Clin Liver Dis 2015 May;19(2):223-38. DOI: 10.1016/j.cld.2015.01.001.

McEvoy SH, McCarthy CJ, Lavelle LP, Moran DE, Cantwell CP, Skehan SJ, et al. Hepatocellular carcinoma: illustrated guide to systematic radiologic diagnosis and staging according to guidelines of the American Association for the Study of Liver Diseases. Radiographics 2013 Oct;33(6):1653-68. DOI: 10.1148/rg.336125104.

Hafeez Bhatti AB, Dar FS, Waheed A, Shafique K, Sultan F, Shah NH. Hepatocellular Carcinoma in Pakistan: National Trends and Global Perspective. Gastroenterol Res Pract 2016;2016:5942306. DOI: 10.1155/2016/5942306.

Farooqi JI, Farooqi RJ. Prevalence of Hepatocellular Carcinoma in Patients of Liver Cirrhosis: An Experience in North West Frontier Province (NWFP). J Coll Physicians Surg Pak. 2000;10(2):54-5.

Yan BC, Gong C, Song J, Krausz T, Tretiakova M, Hyjek E, et al. Arginase-1: a new immunohistochemical marker of hepatocytes and hepatocellular neoplasms. Am J Surg Pathol 2010 Aug;34(8):1147-54. DOI: 10.1097/PAS.0b013e3181e5dffa.

Poynard T, Ratziu V, Charlotte F, Goodman Z, McHutchison J, Albrecht J. Rates and risk factors of liver fibrosis progression in patients with chronic hepatitis c. J Hepatol 2001 May;34(5):730-9. DOI 10.1016/S0168-8278(00)00097-0

Thabut D, Le Calvez S, Thibault V, Massard J, Munteanu M, Di Martino V, et al. Hepatitis C in 6,865 patients 65 yr or older: a severe and neglected curable disease? Am J Gastroenterol 2006 Jun;101(6):1260-7. DOI: 10.1111/j.1572-0241.2006.00556.x

Frith J, Jones D, Newton JL. Chronic liver disease in an ageing population. Age Ageing 2009 Jan;38(1):11-8. DOI: 10.1093/ageing/afn242.

Lin MT, Chen CL, Wang CC, Cheng YF, Eng HL, Wang JH, et al. Diagnostic sensitivity of hepatocellular carcinoma imaging and its application to non-cirrhoticpatients. J Gastroenterol Hepatol 2011 Apr;26(4):745-50. DOI: 10.1111/j.1440-1746.2010.06501.x.

Colli A, Fraquelli M, Casazza G, Massironi S, Colucci A, Conte D, et al. Accuracy of ultrasonography, spiral CT, magnetic resonance, and alpha-fetoprotein in diagnosing hepatocellular carcinoma: a systematic review. Am J Gastroenterol 2006 Mar;101(3):513-23. DOI: 10.1111/j.1572-0241.2006.00467.x

Kim TK, Lee E, Jang HJ. Imaging findings of mimickers of hepatocellular carcinoma. Clin Mol Hepatol 2015 Dec;21(4):326-43. DOI: 10.3350/cmh.2015.21.4.326.