DIAGNOSTIC ACCURACY OF DOPPLER ULTRASOUND IN DETECTION OF PORTAL VEIN THROMBOSIS IN PATIENTS WITH HEPATOCELLULAR CARCINOMA TAKING COMPUTED TOMOGRAPHY (CT) AS THE GOLD STANDARD

Abstract

Introduction: Primary liver cancer is the sixth most commonly diagnosed cancer and the third leading cause of cancer-related deaths worldwide, with approximately 906,000 new cases and 830,000 deaths annually.

Objective: To determine the diagnostic accuracy of ultrasound in the detection of portal vein thrombosis in patients with hepatocellular carcinoma, taking computed tomography (CT) as the gold standard.

Materials and methods: This cross-sectional study was conducted at the Department of Diagnostic Radiology, Lahore General Hospital, Lahore. Data was collected through the non-probability consecutive sampling technique. Before participation, informed consent was obtained from each patient, explaining the purpose of the study. Demographic data such as age, gender, obesity (BMI > 25 kg/m²), and the duration of cirrhosis were collected. A thorough history was taken, focusing on symptoms relevant to portal vein thrombosis.

Results: The study included 249 patients, with a mean age of 48.3 ± 9.7 years, ranging from 20 to 60 years. Of the participants, 54.2% were male (135 patients) and 45.8% were female (114 patients). Obesity (BMI > 25 kg/m²) was observed in 34.5% of the patients (86 individuals). The mean duration of hepatocellular carcinoma (HCC) was 2.3 ± 1.5 years, with a duration range from 0.5 to 6 years. Doppler ultrasound showed a sensitivity of 74.1%, specificity of 89.5%, PPV of 81.3%, NPV of 85.7%, and an overall diagnostic accuracy of 82.8%. Higher diagnostic accuracy was observed in patients under 50 years (85.2%, p = 0.03).

Conclusion: It is concluded that Doppler ultrasound is a reliable and non-invasive diagnostic tool for detecting portal vein thrombosis (PVT) in patients with hepatocellular carcinoma (HCC).