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

 Chansik An  ;  Gulbahor Rakhmonova  ;  Kyunghwa Han  ;  Nieun Seo  ;  Jin Young Lee  ;  Myeong-Jin Kim  ;  Mi-Suk Park 
 Clinical and Molecular Hepatology, Vol.23(1) : 57-65, 2017 
Journal Title
 Clinical and Molecular Hepatology 
Issue Date
Adult ; Aged ; Carcinoma, Hepatocellular/complications ; Carcinoma, Hepatocellular/diagnostic imaging* ; Contrast Media/chemistry ; Diagnosis, Differential ; Female ; Hepatitis B/complications ; Humans ; Liver/diagnostic imaging ; Liver Neoplasms/complications ; Liver Neoplasms/diagnostic imaging* ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Multivariate Analysis ; Odds Ratio ; Retrospective Studies ; Sensitivity and Specificity ; Tomography, X-Ray Computed ; Ultrasonography ; alpha-Fetoproteins/analysis
Carcinoma, Hepatocellular ; Surveillance ; Ultrasonography
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.
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1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Myeong Jin(김명진) ORCID logo https://orcid.org/0000-0001-7949-5402
Park, Mi-Suk(박미숙) ORCID logo https://orcid.org/0000-0001-5817-2444
Seo, Nieun(서니은) ORCID logo https://orcid.org/0000-0001-8745-6454
An, Chansik(안찬식) ORCID logo https://orcid.org/0000-0002-0484-6658
Lee, Jin Young(이진영)
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