Abbreviated Magnetic Resonance Imaging for HCC Surveillance
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Discussion
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Implication
Review reveals superior sensitivity of abbreviated MRI over ultrasound for hepatocellular carcinoma surveillance, indicating its potential as an efficient screening tool.
Key Points
- To review the diagnostic performance, clinical feasibility, and cost-effectiveness of abbreviated magnetic resonance imaging (AMRI) protocols compared to ultrasound for hepatocellular carcinoma (HCC) surveillance in high-risk populations.
- Synthesized literature on noncontrast (NC-AMRI), dynamic contrast-enhanced (Dyn-AMRI), and gadoxetate-enhanced hepatobiliary phase (HBP-AMRI) protocols.
- Compared diagnostic accuracy against standard ultrasound (with or without serum alpha-fetoprotein) and standard full-protocol MRI across retrospective simulation studies and clinical cohorts.
- Standard ultrasound demonstrated a pooled sensitivity of 84% for all-stage HCC but dropped to 45% (and 27.9%-31.7% in prospective studies) for early-stage HCC.
- NC-AMRI achieved per-patient sensitivity of 61.5%-86.1% and specificity of 92.7%-97.9%, outperforming ultrasound in a prospective screening cohort (sensitivity 79.1% vs 27.9%, specificity 97.9% vs 94.5%).
- Contrast-enhanced protocols showed higher sensitivity, with HBP-AMRI achieving 80.6%-89.7% sensitivity (specificity 92.7%-96.1%) and Dyn-AMRI achieving 84.6%-92.1% sensitivity (specificity 88.6%-99.8%).
Cite This Study
Violi et al. (2021) studied this question.