Abstract
Introduction: Liver masses present a significant clinical challenge due to their diverse etiologies, ranging from benign lesions to malignant tumors. Accurate diagnosis is crucial for determining appropriate management strategies and improving patient outcomes.
Objectives: This study aims to evaluate the diagnostic value of computed tomography (CT) scans compared with ultrasound-guided needle biopsy in assessing liver masses.
Patients and Methods: This retrospective diagnostic study, conducted at Firoozgar hospital in Tehran, Iran, aimed to compare the diagnostic value of CT scans and ultrasound-guided needle biopsies in identifying liver masses among 99 adult patients who underwent both procedures between 2015 and 2020. Data collected included patient demographics, clinical characteristics, imaging findings from intravenous contrast-enhanced CT scans, and pathology results from biopsies. Using biopsy pathology as the reference standard, the study calculated the diagnostic accuracy, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of CT scans to evaluate their reliability in diagnosing liver masses and determining tumor nature and metastatic potential.
Results: The diagnostic value of CT scans compared to ultrasound-guided needle biopsy pathology as the gold standard in diagnosing liver tumor characteristics is summarized as follows; for malignant tumors, the accuracy is 73.6%, with a sensitivity of 97.2%, specificity of 50%, PPV of 66.03%, NPV of 94.7%, and a Kappa value of 0.542. In contrast, for metastatic tumors, the accuracy is higher at 81.2%, with a sensitivity of 94.9%, specificity of 67.5%, PPV of 74.4%, NPV of 93%, and a Kappa value of 0.650.
Conclusion: In conclusion, these findings indicate that while CT scan is a valuable non-invasive tool for diagnosing liver masses, its observer-based nature necessitates the use of ultrasound-guided needle biopsy to improve diagnostic accuracy. Combining these methods will enhance clinical decision-making and ensure more reliable assessments of liver tumors.