USEFULNESS OF INDOCYANINE GREEN INJECTION DURING ULTRASOUND-GUIDED LIVER-BIOPSY FOR THE DIAGNOSIS OF SMALL HEPATOCELLULAR-CARCINOMA

To diagnose hepatocellular carcinoma (HCC) functionally and immediatel y, we examined the usefulness of indocyanine green (ICG) injection dur ing ultrasound-guided liver biopsy. Liver specimens were obtained afte r intravenous ICG injection by ultrasound-guided biopsy from 251 space -occupying lesions (SOL) in 136 patients. The tissues were immediately examined for ICG uptake using an infrared Vidicon camera and were als o subjected to histopathological examinations. Of the 112 ICG-negative biopsy specimens, 105 were histologically diagnosed as HCC, 6 as dysp lastic nodules (DN) and 1 as a regenerative nodule (RN). Of the 139 IC G-positive specimens, 18 were diagnosed as HCC, 1 as DN and 120 as RN. The sensitivity of the absence of ICG uptake (SEAIU), the specificity of the absence of ICG uptake (SPAIU), and the positive predictive val ue of the absence of ICG uptake (PPAIU) for the diagnosis of HCC were 85.3%, 94.5% and 93.8%, respectively. Of the 251 SOLs, 184 were less t han 2 cm. SEAIU, SPAIU and PPAIU for the diagnosis of these small HCC were 85.3%, 94.5% and 91.4%, respectively. These results support the r eliability of ICG injection during ultrasound-guided liver biopsy to d iagnose even small HCC.