DIAGNOSTIC ACCURACY OF HEPATIC TUMOR INDEX ON DOPPLER SONOGRAPHY FOR THE DIAGNOSIS OF HEPATOCELLULAR CARCINOMA

Objective: The purpose of this study was to determine the Diagnostic Accuracy of Hepatic Tumor Index (HTI) on Doppler Sonography for the diagnosis of Hepatocellular carcinoma (HCC) while differentiating it from other very closely resembling pathologic lesions like Metastases and Hepatic hemangiomas. Material and Methods: The study was held in the Department of Diagnostic Radiology, Lahore General Hospital, Lahore. All patients included in the study were within the ages of 20-70 years and from both genders who attended indoor and outpatient departments from June 2012 to June 2013. Color Doppler Ultrasonography (CDUS) was done on 105 patients with irregular hepatic lesions less than 03 cm in diameter. The HTI was estimated as the ratio of the tumoral peak systolic velocity (PSV) to the PSV of the right or left hepatic artery. The results of Doppler Sonography and Histopathology were compared taking Histopathology as gold standard. Results: Out of 105 positive cases, the HTI was 1.0 or greater in 91 cases suggesting that those patients had hepatoma while HTI was less than 1.0 in 14 cases suggesting such patients to be harboring tumors other than hepatocellular carcinoma (HCC). Hence in hepatic lesions a tumoral PSV equal to or greater than 0.40 m/sec and HTI equal to 1.0 or greater was related with 97.78 % sensitivity, 80% specificity , 96.70 % positive predictive value, 85.71 % negative predictive value and 95.23 % diagnostic accuracy in differentiating HCC from hepatic metastases and hemangiomas. Conclusion: The HTI on CDUS is useful in differentiating HCC from other hepatic lesions especially hepatic metastases or hemangiomas. We strongly recommend CDUS for the evaluation of HCC because it is highly accurate, easily available and non-invasive imaging modality for its diagnosis.