Abstract:

Aim: was to determine the possibility of ultrasound in the diagnosis of hepatocellular carcinoma (HCC).

Materials and methods: the study involved 140 patients who underwent surgical treatment for the period 1998-2013 years. HCC was confirmed in 127 patients, 12 patients had benign tumors, such as hepatocellular adenoma, focal nodular hyperplasia.

Results: ultrasound features of hepatocellular carcinoma were studied. To determine the informativeness, results were compared with preoperative methods of examination, intraoperative ultrasound (IOUS) and histological examination with surgical evaluation and histologic data. Number of tumor nodules, determined by ultrasound confirmed in 74% of cases with HCC and 83,3% for benign diseases. Dimensions, which were measured by ultrasound, were confirmed in majority cases (81,1%) with HCC and 100% of cases with benign tumors. Sensitivity and specificity of ultrasound were 99,2% and 25%, CT - 96,9% and 28,6%, MRI - 100% and 33,3% respectively Aspiration biopsy showed the most balanced performance: sensitivity - 94,9%, specificity 45,4%. Lack of true negative results during angiography, IOUS and surgical evaluation did not gave possibilities to calculate the specificity and predictive value of a negative result. Sensitivity of IOUS and surgical evaluation were 98,8% and 97,6%, respectively Of all tumor markers used in the diagnostic process, none of all showed any significant sensitivity, but they were characterized by high specificity and positive predictive method predictability

Conclusions: US strategy in the diagnosis of HCC is to identify neoplasm, conducting navigation during fine-needle aspiration biopsy, specifying diagnostics during surgery. Results showed highly informative diagnostic value of ultrasound at all stages of the examination and treatment of patients with HCC. 

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Abstract:

Aim: was to estimate the diagnostic value of PET with ¹⁸F-Choline and ¹⁸F-FDG in case of mixed hepatocellular (HCC) and cholangiocellular cancer (CCC).

Materials and methods: PET/CT with ¹⁸F-Choline and ¹⁸F-FDG was performed on 70 years old patient, with diagnosed hepatobilliary cancer. CT scan and MRI with intravenous contrast-enhanced, histological and immunohistochemical study of postoperative material (right-sided hemihepatectomy) were also performed.

Results: difference in the accumulation of ¹⁸F-Choline and ¹⁸F-FDG in some areas of mixed hepatocellular and cholangiocellular cancer was detected: in the field of cholangiocellular cancer and ir the field of poorly differentiated hepatocellular cancer.

Conclusions: ¹⁸F-choline has a low diagnostic value in the detection of cholangiocellular cancer and poorly differentiated HCC, in contrast to ¹⁸F-FDG, whereas at high differentiated HCC study, ¹⁸F-choline is more preferable. Diagnostic value of ¹⁸F-FDG at high differentiated HCC is extremely low.

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