Research examines how liver cancer could be misclassified

Diagnosing strains of liver cancer can be difficult because they are usually simila, but physicians have various tools to help them. Now, new research at Washington University in St. Louis has found these approaches may not always be accurate.

The study, published in the July issue of the American Journal of Roentgenology, found that biphenotypic primary liver carcinoma, a type of liver cancer, can sometimes be misclassified as hepatocellular carcinoma (HCC), based on limited interpretations of liver images that only show major features. Based on those narrow interpretations, patients aren’t always diagnosed correctly.

The study was led by Theodora Potretzke, MD, an abdominal imaging fellow at the Mallinckrodt Institute of Radiology at Washington University's School of Medicine. She and her team used a liver imaging reporting and data system to help them assess and classify liver lesions.

They reviewed pathologically proven biphenotypic primary liver carcinomas in 61 patients who were diagnosed between 2006 and 2014. Through studying the major features alone, 22 of the 61 lesions met the criteria for HCC, meaning they could have been misclassified.

Ultimately, the method was accurate for classifying most of the biphenotypic primary liver carcinomas as non-HCC malignancy because of the inclusion of ancillary features, like peripheral arterial phase hyperenchancement. But it wasn’t completely accurate.

Looking ahead, to make the method more accruate, researchers suggested that ancillary features be added to improve diagnostic accuracy for systems that only examine major features.