Comparative Diagnostic Accuracy of CT and MRI in Detecting Hepatocellular Carcinoma with Emphasis on Small Lesions: A Cross-Sectional Study

Abstract

Background: Hepatocellular carcinoma (HCC) is the most prevalent primary liver malignancy and a leading cause of cancer-related mortality worldwide. Early detection, particularly of small lesions, is vital for curative treatment. Objective: To compare the diagnostic accuracy of computed tomography (CT) and magnetic resonance imaging (MRI) in detecting HCC, with emphasis on small lesions. Methods: A cross-sectional study was conducted at Allied Hospital Faisalabad on 40 patients suspected of HCC in 6 months. Twenty underwent CT and twenty underwent MRI. Sensitivity, diagnostic accuracy, and detection of small lesions (<2 cm) were analyzed using SPSS v26. Results: MRI showed superior diagnostic accuracy (82%) compared with CT (57%). For small lesions (<2 cm), MRI detected 55.6% while CT detected only 18.8%. MRI also demonstrated higher sensitivity in identifying arterial phase hyperenhancement and washout patterns. CT remained faster, more accessible, and cost-effective, but involved radiation. Conclusion: MRI is superior for early detection of HCC, particularly in high-risk patients, while CT remains valuable in emergency and resource-limited settings. Strategic use of both modalities can optimize patient care.

Keywords: Hepatocellular carcinoma, CT, MRI, diagnostic imaging, liver cancer, small lesions