Contribution of medical imaging in the diagnosis of hepatocellular carcinoma at the CNHU-HKM in Cotonou

Introduction: The World Health Organization (WHO) and the Global Cancer Observatory rank hepatocellular carcinoma (HCC) as the sixth most common cancer in the world and the fourth leading cause of cancer death. According to GLOBOCAN 2022, sub-Saharan Africa is a very highly endemic area. In Benin, despite the high frequency of cirrhosis and viral liver disease, local data remain limited. This study aimed to evaluate the contribution and compare the performance of medical imaging techniques (ultrasound and CT) in the diagnosis of HCC at the CNHU-HKM in Cotonou.
Methods: This was a retrospective, descriptive and analytical study conducted over a one-year period (from 23 May 2023 to 23 May 2024) using the Cotonou Cancer Registry. The study comprehensively included 118 patients suspected of HCC.
Results: The mean age of the patients was 47.46 years with a clear male predominance (sex ratio: 3.72). The main etiologies identified were viral hepatitis B (61.02%) and chronic alcoholism (37.28%). On ultrasound, hypervascular nodules on cirrhotic liver were hypervascularized on cirrhotic liver. On multiphase CT scan, HCC was characterized by arterial wash-in (94.91%) followed by portal wash-out (90.67%). CT had a higher sensitivity (98.1%) than ultrasound (85.2%), while ultrasound maintained perfect specificity (100%).
Conclusion: The complementarity of ultrasound and CT remains essential to optimize the non-invasive diagnostic management of HCC in our health context.