Screening of patients with chronic liver disease for hepatocellular carcinoma by ultrasonography.

The accuracy of real-time ultrasonography in screening for hepatocellular carcinoma at the out-patient Liver Clinic was prospectively evaluated in 245 patients with chronic liver disease. There were 14 patients with hepatocellular carcinoma who had no specific symptoms related to it. Tumour was detected by ultrasonography in 12 patients, but it missed the tumour in two patients. There were also three false positive results. The sensitivity and specificity of ultrasonography in the diagnosis of hepatocellular carcinoma were 85.7% and 98.8%, respectively. These are superior to alpha-fetoprotein (AFP) measurement, especially in specificity (p less than 0.01) at 19 ng/ml cut-off. False negative results were compensated for by AFP and computed tomography. A decision on treatment schedule was easily made on an anatomical basis by ultrasonographic examination.