Evaluation of hepatic mass on ultrasound keeping triphasic multi detector computed tomography as gold standard.

Abstract

Objective: To evaluate the diagnostic performance of ultrasound in identifying hepatic mass using triphasic multi-detector computed tomography (MDCT) as the gold standard. Study Design: Prospective Observational, Validation study. Setting: Department of Radiology, Combined Military Hospital, Gujranwala, Pakistan. Period: January 2024 to December 2024. Methods: The inclusion criteria were age between 18-80 years, and presenting with focal hepatic lesions greater than 2 cm in size (as per ultrasound). All patients subsequently underwent triphasic MDCT of the liver within a maximum of two weeks of the initial ultrasound. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of ultrasound compared to triphasic MDCT, were calculated. Receiver operating characteristics curves were drawn to calculate area under the curve (AUC) with 95% confidence interval. All statistical analyses were performed using IBM-SPSS Statistics, version 26.0. Results: In a total of 64 patients, 41 (64.1%) were males and 23 (35.9%) females. The mean age was 47.27±17.02 years, ranging between 18-80 years. Ultrasonography identified hepatic mass in 25 (39.1%) cases. The MDCT revealed positive findings for hepatic mass in 25 (39.1%) cases. Sensitivity, specificity, PPV, NPV, and accuracy of ultrasonography findings with respect to MDCT in diagnosing hepatic mass were 88.0%, 92.3%, 88.0%, 92.3%, and 90.6%, respectively. ROC curve analysis of ultrasonography findings taking MDCT as gold standard in diagnosing hepatic mass showed AUC as 0.902 with 95% CI of 0.813-0.990, p<0.001. Conclusion: The ultrasonography demonstrates high sensitivity and positive predictive value in detecting hepatic lesions, and serves as a valuable first-line modality.