Imaging and pathology report agreement in patients undergoing liver biopsy at university teaching hospitals in Kigali

Abstract

Background Liver cancer and metastasis are highly malignant conditions that pose a significant threat to human life with an extremely high fatality rate. Computed tomography (CT) and magnetic resonance imaging are crucial in characterizing the liver masses as either benign or malignant. The objective of this retrospective study was to investigate agreement between the imaging and pathology features of liver masses in patients who underwent CT imaging and subsequent biopsies at teaching hospitals in Kigali. Method The study involved 162 patients with pathological results and imaging reports from January 2020 to June 2024. Each liver mass was recorded for its imaging diagnosis and corresponding pathology results. The diagnoses were categorized into two groups: benign or malignant masses. Statistical agreement test (kappa test) between imaging diagnosis and pathological results was assessed, then sensitivity, specificity and diagnostic accuracy were also calculated. Results A total number of 162 patients were recruited for this study. Mean age of all patients was 55.7 years SD of 16.5 with a range of 2 years to 87 years. The majority of patients were aged between 40 years to 80 years. A high number of malignant cases recorded in Kigali Town. The most pathological diagnoses were liver metastases 80(49.4%) and hepatocellular carcinoma along with its subcategories 32(19.8%). Agreement between imaging diagnosis and pathological diagnosis was statistically significant, with a substantial Kappa coefficient of 0.78 (P value < 0.0001). Sensitivity of CT to diagnose malignant masses was 98.6%, specificity 73.8%, diagnostic accuracy 95.0%, positive predictive value 95.8% and negative predictive value 89.4%. Conclusion: The findings of our study concluded that CT scan is an accurate tool to diagnose liver masses especially malignant masses.