DefinePK

Abstract

Background: Hepatocellular carcinoma (HCC) is the most prevalent primary liver malignancy and remains a leading cause of cancer-related deaths worldwide. The condition is often associated with chronic liver disease (CLD), particularly in high-prevalence regions like Pakistan. Timely and accurate diagnosis plays a crucial role in improving treatment outcomes. Quantitative washout on triphasic computed tomography (CT) has emerged as a promising non-invasive imaging biomarker for HCC, offering objective assessment of lesion behavior during contrast-enhanced phases.
Objective: To determine the diagnostic accuracy of quantitative washout on triphasic CT in diagnosing hepatocellular carcinoma, using histopathological findings as the gold standard.
Methods: A cross-sectional study was conducted at the Dow Institute of Radiology, Dow University of Health Sciences, from 11th October 2024 to 11th April 2025. A total of 192 patients aged 30–80 years with clinical suspicion of HCC underwent triphasic CT scans. Delayed phase attenuation values were measured to calculate quantitative washout. All patients subsequently underwent liver biopsy, and histopathology served as the reference standard. Data analysis was performed using SPSS version 22.0. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and overall diagnostic accuracy were calculated using 2 × 2 contingency tables.
Results: The mean age of participants was 54.49 ± 10.88 years, with 124 (64.6%) males and 68 (35.4%) females. Mean quantitative washout was 141.99 ± 28.63 Hounsfield Units. Quantitative washout on CT identified HCC in 170 (88.5%) patients, while histopathology confirmed HCC in 162 (84.4%). The diagnostic parameters showed sensitivity of 100.00%, specificity of 73.33%, PPV of 95.29%, NPV of 100.00%, and diagnostic accuracy of 95.83%.
Conclusion: Quantitative washout on triphasic CT is a highly sensitive and accurate imaging technique for diagnosing hepatocellular carcinoma, supporting its integration into diagnostic protocols for CLD patients.