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Hepatology International

, 3:544 | Cite as

Ultrasound surveillance for early detection of hepatocellular carcinoma among patients with chronic hepatitis C

  • Takahisa Sato
  • Ryosuke Tateishi
  • Haruhiko Yoshida
  • Takamasa Ohki
  • Ryota Masuzaki
  • Jun Imamura
  • Tadashi Goto
  • Fumihiko Kanai
  • Shuntaro Obi
  • Naoya Kato
  • Shuichiro Shiina
  • Takao Kawabe
  • Masao Omata
Original Article

Abstract

Background and aims

Ultrasonography is the most frequently used modality in surveillance for HCC among patients with chronic hepatitis C. However, the optimal surveillance interval is still controversial and the usefulness of supplementary tumor marker determination has not been confirmed.

Methods

A total of 243 cases of naive HCC were detected among 1,431 patients with chronic hepatitis C under outpatient-based surveillance. The mode of HCC detection, including ultrasound surveillance interval, was retrospectively examined and the relation between the interval and detected tumor size was analyzed. Tumor volume doubling time was estimated from exponential increase in serum tumor marker levels when applicable.

Results

HCC was first detected by ultrasonography in 221 patients. Ultrasound surveillance interval, ranging between 2 and 8 months, was not correlated with the size of tumor at detection. Patients with cirrhosis were likely to be surveyed at shorter intervals. The size of tumor exceeded 30 mm only in three (1.4%) cases. They were all positive for a biomarker and the estimated tumor doubling time was short. In 14 cases, HCC was first detected by CT indicated by abnormal rise in tumor marker levels despite negative ultrasound findings. In the remaining eight cases, ultrasonography had been replaced by CT as surveillance modality because of excessive obesity or coarseness of liver parenchyma.

Conclusions

Ultrasound surveillance at 6-month intervals was appropriate in general for the detection of HCC at a size smaller than 30 mm. However, in patient with established cirrhosis, more frequent screening would be needed to detect tumors of the same size.

Keywords

Hepatocellular carcinoma Hepatitis C Surveillance Ultrasound Tumor marker Doubling time Size of tumor Surveillance interval 

Abbreviations

AFP

α-Fetoprotein

CT

Computed tomography

DCP

Des-γ-carboxy prothrombin

HBsAg

HBV surface antigen

HCC

Hepatocellular carcinoma

MRI

Magnetic resonance imaging

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Copyright information

© Asian Pacific Association for the Study of the Liver 2009

Authors and Affiliations

  • Takahisa Sato
    • 1
  • Ryosuke Tateishi
    • 1
  • Haruhiko Yoshida
    • 1
  • Takamasa Ohki
    • 1
  • Ryota Masuzaki
    • 1
  • Jun Imamura
    • 1
  • Tadashi Goto
    • 1
  • Fumihiko Kanai
    • 1
  • Shuntaro Obi
    • 1
  • Naoya Kato
    • 1
  • Shuichiro Shiina
    • 1
  • Takao Kawabe
    • 1
  • Masao Omata
    • 1
  1. 1.Department of GastroenterologyUniversity of TokyoTokyoJapan

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