Role of Triphasic Computed Tomography in Evaluation of Hepatic Lesions: Comparative Cross-Sectional Study

Abstract

Focal hepatic lesions may be benign or malignant and can be difficult to characterize with ultrasound alone. Multiphase contrast-enhanced computed tomography provides dynamic information about lesion vascularity and enhancement, which can improve lesion characterization and guide further management. Objectives: To determine the diagnostic accuracy of triphasic computed tomography (TPCT) in differentiating benign from malignant hepatic lesions using fine-needle aspiration cytology (FNAC) as the reference standard. Methods: A comparative cross-sectional study was conducted among 136 patients with focal hepatic lesions. All patients underwent triphasic computed tomography (TPCT), and fine-needle aspiration cytology (FNAC) was used as the reference standard. TPCT findings were compared with FNAC results to determine sensitivity, specificity, positive predictive value, negative predictive value, and overall diagnostic accuracy. Results: Out of 140 enrolled patients, 136 had complete data available for the final analysis. TPCT classified 31 (22.8%) lesions as benign and 105 (77.2%) as malignant, whereas FNAC classified 29 (21.3%) as benign and 107 (78.7%) as malignant. The contingency table showed 104 true positives, 28 true negatives, 1 false positive, and 3 false negatives. Overall diagnostic accuracy was 97.1%. Conclusions: In this single-centre cohort, TPCT demonstrated high diagnostic accuracy for distinguishing benign from malignant focal hepatic lesions. Its high sensitivity and specificity support its value as a non-invasive diagnostic modality, although findings should be validated in larger multi-centre studies.