Evaluation of the added value of imaging the pelvis in patients with hepatocellular cancer

Background and Aim To evaluate added value of the pelvic portion of the CT and MRI examination in patients with a primary diagnosis of HCC. Methods We reviewed the medical records of 478 patients with 881 examinations of the abdomen and pelvis who underwent treatment at our institution between March 2015 and March 2016. These patients were reviewed for presence of pathology in the pelvis, which were classified into 2 categories as new or old (already known on prior imaging). Results Of 478 patients, 230 underwent MRI examination of the abdomen and pelvis and the other 248 underwent CT scans of these regions. There were no findings on the CT or MR of the pelvis in 80.5% of patients (n=385), including 81.5% of those who had CT and 79.6% of those who had MRI. 93 patients had findings in the pelvis, the most common of which were bone metastases (31 patients), ascites (27 patients), implants (7 patients), and bladder wall thickening (5 patients). In only 7.9% of patients, the findings were related to metastatic disease. In 5.4% of all imaging studies revealed a new finding in the pelvis. Conclusion Imaging of the pelvis (CT or MRI) does not seem to provide additional information in the majority of cases with HCC. The results suggest that the follow-up evaluation of patients with HCC may not include a pelvis exam.