A lexicon for hepatocellular carcinoma surveillance ultrasonography: benign versus malignant lesions.
- Author:
Chansik AN
1
;
Gulbahor RAKHMONOVA
;
Kyunghwa HAN
;
Nieun SEO
;
Jin Young LEE
;
Myeong Jin KIM
;
Mi Suk PARK
Author Information
- Publication Type:Original Article
- Keywords: Carcinoma, Hepatocellular; Surveillance; Ultrasonography
- MeSH: Acoustics; Carcinoma, Hepatocellular*; Humans; Liver; Logistic Models; Retrospective Studies; Ultrasonography*
- From:Clinical and Molecular Hepatology 2017;23(1):57-65
- CountryRepublic of Korea
- Language:English
- Abstract: 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.
