Sarcouncil Journal of Internal Medicine and Public Health

Abstract: Background:Hepatocellular carcinoma (HCC) is the most common primary liver cancer and a major contributor to cancer-related mortality worldwide. Early and accurate detection, especially of small lesions, is crucial for improving patient outcomes.Objective:This study aims to compare the diagnostic accuracy of computed tomography (CT) and magnetic resonance imaging (MRI) in detecting HCC, with particular emphasis on small hepatic lesions. Method: A cross-sectional validation study was conducted on 40 patients in the Radiology Department of Allied Hospital Faisalabad over a period of six months. Patients underwent either CT or MRI according to predefined inclusion criteria. Imaging findings were analyzed using SPSS version 26, assessing sensitivity, lesion size detection, and key diagnostic features such as arterial phase hyperenhancement and washout. Results: MRI demonstrated higher diagnostic accuracy (~82%) compared with CT (~57%), particularly for small lesions (<2 cm), identifying 55.6% of these cases versus 18.8% with CT. MRI also showed greater sensitivity in detecting characteristic vascular patterns of HCC. Although CT was faster and more accessible, it involved radiation exposure and showed lower performance for early-stage lesions.Conclusion: MRI provides superior diagnostic performance compared to CT for the early detection of HCC, especially in high-risk individuals. CT remains valuable in emergency and resource-limited settings. Optimal patient management may be achieved through combined or selective use of both imaging modalities.