Role of Transient Elastography in Early Detection of HCC in Cirrhotic Patients

Badran, Abdel Ghani Atef; El-Tokhy, Naglaa Ramadan; Seif, Seham Mohamad; Baioumy, Hossam Amin

doi:10.21608/aeji.2017.17792

Role of Transient Elastography in Early Detection of HCC in Cirrhotic Patients

Document Type : Original Article

Authors

¹ Liver and GIT center,Damas, Meet Ghamr,Dakahlia,Egypt

² GIT, Hepatology and infectious DiseasesDepartment , Faculty of Medicine , Benha University

³ Internal Medicine (GIT and Hepatology)Department , Faculty of Medicine, Mansoura University

10.21608/aeji.2017.17792

Abstract

Background and study aim: Hepatocellular carcinoma (HCC) is common primary malignancy of the liver and one of the most frequent causes of death in patients with liver cirrhosis.Nowadays, liver stiffness measured non-invasively by transient elastography has been reported to be well correlated with histologically assessed liver ﬁbrosis stage. The degree of liver fibrosis is the strongest indicator of risk for HCC development, that’s why liver stiffness measured by transient elastography is helpful in demarcating patients at a high risk for HCC, who need frequent check-up by imaging examinations.The aim of this study was to study the role of ultrasound elastography (FibroScan) in early detection of hepatocellular carcinoma in cirrhotic patients as well as verifying whether ultrasound elastography (Fibro-Scan), could be used as a tool for identifying cirrhotic patients who are at high risk of developing HCC.
Patients and Methods: This study included 100 patients; 50 with HCC and 50 cirrhotics without evidence of HCC . For all groups, clinical data and image findings were studied. Tumour characteristics were assessed including size, number and site. Tumor staging was done using Okuda, CLIP, VISUM and Tokyo staging systems. Transient elastography was done for all patients and the results were expressed in kilopascal.
Results: Liver stiffness was significantly higher in HCC patients compared to cirrhotic patients. The sensitivity and specificity in diagnosis of HCC were 72% and 84% respectively at cut-off of 30.4 kpa with 91.1% accuracy. Fibroscan has a positive significant correlation with tumour size (P<0.001), Child–Pugh (P<0.001), Okuda classification (P<0.001), CLIP staging (P<0.001) and Tokyo classification (P<0.001) among HCC patients. It was found that likelihood of HCC risk was correlated with increase of liver stiffness. At liver stiffness of 25-30 kpa the probability of HCC is 91% so, these patients should undergo close follow up. Patients with stiffness ≥30 kpa had HCC.
Conclusion: Fibroscan could be used for early detection of HCC in cirrhotic patients and determining the patients who are at high risk for developing HCC.

Keywords

Main Subjects