Performance of Imaging for the Diagnosis of Small Hepatocellular Carcinoma (< 3 cm)on Cirrhosis
With the improvement of cirrhosis complications coverage, hepatocellular carcinoma (HCC)
tend to become the main cause of mortality for cirrhotic patients. Currently, the incidence
of the HCC increase in occidental country and hid global prognostic remain very bad. The
main indication factor for a curative treatment is the size lesion.
Cirrhosis is the main risk factor for HCC occurence. In France, HCC screening has been
establish for cirrhotic patients with hepatic ultrasound and alfa-fetoprotein measurement
with the aim of detected HCC when the size allows a curative treatment.
When a nodule is discovered during the follow-up, HCC diagnosis is done following the
recommendations of European Association for the Study of the Liver (AESL) in 2000, updated
by the American Association for the Study of Liver Diseases (AASLD)in 2005. Diagnostic is
function of nodule feature on one or two enhanced imaging techniques among CTscanner, MRI
and enhanced contrast ultrasound.
This diagnostic strategy raises several questions. First, neither the most efficient dynamic
imaging association for nodules from 1 to 2 cm, nor the most efficient imaging examination
for nodules from 2 to 3 cm are known. Second, only few studies have been carried out about
imaging semiology of the small hepatocellular carcinoma. Thus, the imprecisions of the
present recommendations regarding the choice of the best examination technique and the
difficulties in the diagnosis of benign or malignant nature for small nodule can lead to a
bad management of these patients.
Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Diagnostic
Report of proportion of the positives truths and the positive wrong for an examination
France: Ministry of Health