ROLE OF CONTRAST-ENHANCED COMPUTED TOMOGRAPHY IN THE EVALUATION OF HEPATOCELLULAR CARCINOMA IN CHRONIC LIVER DISEASE

Abstract

Background: Hepatocellular carcinoma (HCC) represents a significant global health burden, particularly among individuals with chronic liver disease. Contrast-enhanced computed tomography (CECT) is the primary imaging modality for evaluating HCC.

Objective: This study aimed to assess the demographic characteristics and imaging features of HCC in patients with chronic liver disease using CECT, with emphasis on lesion location, margins, and associated findings.

Methods: This analytical cross-sectional study was conducted at the Department of Radiology, Shalamar Hospital, Lahore, over a four-month period. A total of 140 patients diagnosed with HCC and chronic liver disease were enrolled using consecutive sampling. All participants underwent multiphasic CECT using a 64-slice Siemens CT scanner with a standardized protocol (120 kVp, 120-170 mAs, 100-120 mL non-ionic contrast at 3-5 mL/s). Data on demographic characteristics, clinical presentations, and imaging features, including lesion location, margins, and associated findings, were collected using a structured pro forma. Statistical analysis was performed using SPSS version 25, with descriptive statistics presented as frequencies and percentages.

Results: The study population comprised 111 males (79.3%) and 29 females (20.7%), demonstrating a strong male predominance. Fatigue was the most common symptom (65.0%), followed by fever (57.9%) and nausea (54.3%). Abdominal distention was present in 79.3% of patients. Regarding lesion characteristics, segment III was the most frequent location (25.0%), followed by segment IV (22.9%) and segment II (15.7%). Irregular margins were observed in 58.6% of lesions. Fatty liver appearance was predominant (90.0%), while fibrotic changes were noted in 8.6% of cases. Ascites was present in 39.3% of patients, and free fluid collection was observed in 85.8% of cases. Pain in the right and left hypochondriac regions was reported in 27.8% and 30% of patients, respectively.

Conclusion: CECT demonstrates high sensitivity in detecting and characterizing HCC in patients with chronic liver disease. The modality provides detailed information on lesion location, margins, and associated findings, which are essential for treatment planning. The study confirms a male predominance in HCC incidence, with segment III the most common location. These findings support the continued use of CECT as the primary imaging modality for evaluating HCC.