This Article Full Text (PDF) Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Powell-Jackson, P. Articles by Williams, R. Search for Related Content PubMed PubMed Citation Articles by Powell-Jackson, P. Articles by Williams, R.

Effect of cirrhosis on accuracy of ⁹⁹Tc^m-tin colloid scintigraphy and ultrasound scanning in diagnosis of hepatocellular carcinoma

P. Powell-Jackson, M.D., M.R.C.P. ^* A. Forbes, B.Sc., M.R.C.P. M. Michell, M.B., F.R.C.R. and Roger Williams, M.D., F.R.C.P.

Liver Unit, King's College Hospital and King's College School of Medicine and Dentistry, Denmark Hill, London SE5 9RS Department of Radiology, King's College Hospital and King's College School of Medicine and Dentistry, Denmark Hill, London SE5 9RS

The effect of cirrhosis on the accuracy of ultrasonography and scintigraphy in the diagnosis of hepatocellular carcinoma (HCC) has not been established. We have therefore studied the findings on ultrasound and scintigraphy in four groups of patients. Fourteen had HCC and cirrhosis, 13 had HCC but no cirrhosis, 53 had cirrhosis but no HCC and 31 had evidence neither of cirrhotic nor malignant liver disease. The accuracies of a positive interpretation of HCC on ultrasound and scintigraphy in the absence of cirrhosis were 85% and 66% respectively (NS), but fell (significantly in the case of scintigraphy: p < 0.05) to 80% and 31% respectively in the presence of cirrhosis (p < 0.01). The poorer performance of scintigraphy in the presence of cirrhosis was a result both of its lower sensitivity (50% compared with 85%) and the greater frequency of false positives (28% vs 5%: p < 0.001). The accuracy of a negative interpretation of HCC on scintigraphy in the absence of cirrhosis was 96% but fell to 84% in the presence of cirrhosis, whereas on ultrasound it remained the same (96%). In conclusion, we recommend ultrasound in preference to scintigraphy as a more accurate technique for the diagnosis of HCC in the presence of cirrhosis.

^* Present address: Department of Health Care of the Elderly, Dulwich Hospital, London SE22.

Author for correspondence.

Received for publication February 1, 1987. Revision received March 1, 1987.