Localization of small liver tumors

Area of Science:

• Hepatology
• Surgical Oncology
• Diagnostic Imaging

Background:

• Small liver tumors pose diagnostic challenges, impacting treatment decisions.
• Accurate preoperative and intraoperative localization is crucial for successful surgical resection.
• Hepatocellular carcinoma (HCC), hepatic cavernous hemangioma, and secondary liver cancer are common types.

Purpose of the Study:

• To assess the diagnostic accuracy of alpha-fetoprotein (AFP), sonography, and computed tomography (CT) for small liver tumors.
• To introduce and evaluate an intraoperative detection method for non-palpable or invisible small liver tumors.
• To report the outcomes of hepatectomy for small liver tumors.

Main Methods:

• Retrospective analysis of 36 patients with small liver tumors undergoing hepatectomy.
• Comparison of diagnostic accuracy rates for AFP, sonography, and CT.
• Description and application of an intraoperative detection technique for challenging tumor localization.

Main Results:

• CT achieved 100% accuracy for HCC and secondary liver cancer, while sonography showed 81.8% accuracy for hemangiomas.
• AFP had a positive rate of only 66.6% for HCC.
• The intraoperative method successfully detected and enabled resection of 7 small, non-palpable tumors.

Conclusions:

• CT and sonography offer complementary diagnostic value for different small liver tumor types.
• AFP has limited sensitivity for HCC detection in this cohort.
• The described intraoperative detection method is effective for locating and resecting small, elusive liver tumors, improving surgical success rates.