Small hepatocellular carcinoma: an Italian experience

Area of Science:

• Hepatology
• Medical Imaging
• Oncology

Background:

• Recent advancements suggest ultrasound's capability in detecting small hepatocellular carcinomas (HCC) less than 3 cm.
• Hepatocellular carcinoma (HCC) remains a significant global health concern, particularly in patients with underlying liver disease.

Purpose of the Study:

• To determine the incidence of small HCC (under 3 cm) in an Italian patient cohort using ultrasonography.
• To evaluate the diagnostic accuracy of ultrasound-guided biopsy for small HCC.

Main Methods:

• Analysis of 17,133 ultrasonographic scans from unselected patients.
• Identification and characterization of HCC, with a focus on lesions smaller than 3 cm.
• Ultrasound-guided biopsy for all detected HCC cases.

Main Results:

• Eighty-five cases of HCC were detected, with 9 (approximately 10.6%) measuring under 3 cm.
• All patients diagnosed with HCC had underlying cirrhosis.
• Six patients with small HCC were positive for Hepatitis B surface antigen (HBsAg).
• Ultrasound-guided biopsy demonstrated 100% diagnostic accuracy for HCC.

Conclusions:

• Ultrasound is effective in detecting small HCC in an Italian population.
• Echographic surveillance is crucial for high-risk individuals, including HBsAg-positive cirrhotics and patients over 35 with chronic aggressive HBsAg-positive hepatitis.
• Findings align with previous reports from Asian studies, supporting global applicability of these surveillance strategies.