DIAGNOSTIC PERFORMANCE OF DYNAMIC CONTRAST-ENHANCED MRI FOR HEPATOCELLULAR CARCINOMA DETECTION IN CHRONIC LIVER DISEASE: CORRELATION WITH HISTOPATHOLOGY

S RANA; S ANJUM; A SATTAR; S BABAR

doi:10.54112/pjicm.v5i02.208

Authors

S RANA Department of Radiology, Shaikh Zayed FPGMI Lahore, Pakistan
S ANJUM Department of Radiology, Nishtar Medical University and Hospital, Multan, Pakistan
A SATTAR Department of Radiology, Nishtar Medical University and Hospital, Multan, Pakistan
S BABAR Department of Radiology, Nishtar Medical University and Hospital, Multan, Pakistan

DOI:

https://doi.org/10.54112/pjicm.v5i02.208

Keywords:

Chronic Liver Disease, Hepatocellular Carcinoma, Dynamic Contrast-Enhanced MRI, Diagnostic Accuracy, Histopathology

Abstract

Background: Chronic liver disease is a major predisposing factor for the development of hepatocellular carcinoma, which remains a leading cause of liver-related mortality worldwide. Early and accurate diagnosis is essential for timely therapeutic intervention and improved survival outcomes. Dynamic contrast-enhanced magnetic resonance imaging has emerged as a non-invasive modality for HCC detection; however, its diagnostic performance requires validation against histopathological confirmation, particularly in resource-limited settings. Objective: To determine the diagnostic accuracy of dynamic contrast-enhanced magnetic resonance imaging in identifying hepatocellular carcinoma among patients with chronic liver disease, using histopathology as the reference standard, and to assess the influence of demographic and clinical factors on imaging performance. Study Design: Cross-sectional diagnostic study. Settings: Department of Diagnostic Radiology, Nishtar Hospital, Multan, Pakistan. Duration of Study: May 2024 to August 2024. Methods: A total of 151 patients with chronic liver disease, aged 30 to 70 years, were enrolled using non-probability consecutive sampling. All participants underwent dynamic contrast-enhanced magnetic resonance imaging followed by percutaneous liver biopsy for histopathological confirmation. Diagnostic performance indices, including sensitivity, specificity, positive predictive value, negative predictive value, and overall accuracy, were calculated. Stratified analyses were performed by age, gender, lesion size, disease duration, and area of residence. Results: Dynamic contrast-enhanced magnetic resonance imaging demonstrated a sensitivity of 94.94%, specificity of 95.83%, positive predictive value of 96.15%, negative predictive value of 94.52%, and an overall diagnostic accuracy of 95.36%. Diagnostic performance was highest for lesions larger than 5 cm, with an accuracy of 98.36%. The accuracy of DCE-MRI remained consistent across different age groups, genders, disease durations, and between rural and urban populations. Conclusion: Dynamic contrast-enhanced magnetic resonance imaging is a highly accurate and reliable non-invasive modality for the diagnosis of hepatocellular carcinoma in patients with chronic liver disease. Its consistent performance across demographic and clinical subgroups supports its use as a primary diagnostic tool to facilitate early diagnosis and timely clinical management.

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