Abbreviated MRI for hepatocellular carcinoma screening: A systematic review and meta-analysis

Gupta, Pankaj; Soundararajan, Raghuraman; Patel, Ankur; Kumar‐M, Praveen; Sharma, Vishal; Kalra, Naveen

doi:10.1016/j.jhep.2021.01.041

Cited by 100 publications

(92 citation statements)

References 40 publications

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“…Dynamic contrast-enhanced AMRI (Dynamic-AMRI) acquires dynamic contrast enhanced images using T1-W sequences with fat suppression following administration of an extracellular contrast medium. The dynamic component describes the images acquisition at pre-determined and successive phases to identify and characterize HCCs based on the vascular pattern [35]. Dynamic-AMRI offers the advantages of to define major features of HCC according to LI-RADS so that dynamic AMRI alone is sufficient to definitive diagnosis of HCC.…”

Section: Discussionmentioning

confidence: 99%

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Abbreviated MRI Protocol for the Assessment of Ablated Area in HCC Patients

Granata

Grassi

Fusco

et al. 2021

IJERPH

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Background: Liver Imaging Reporting and Data Systems (LI-RADS) Treatment Response Algorithm (TRA) was created to provide a standardized assessment of hepatocellular carcinoma (HCC) following loco regional therapy. The aim of this study was to compare sensitivity of standard MRI protocol versus abbreviated protocol (only T1-Weigthed fat suppressed (FS) sequences pre- and post-contrast phase) in the detection of ablated area according to LI-RADS Treatment Response (LR-TR) categories. Methods: From January 2015 to June 2020, we selected 64 patients with HCC, who underwent Radiofrequency ablation (RFA) or Microwave ablation (MWA) treatment. According to inclusion criteria, 136 pathologically proven treated HCC (median 2, range 1–3 per patient; mean size 20.0 mm; range 15–30 mm) in 58 patients (26 women, 32 men; median age, 74 years; range, 62–83 years) comprised our study population. For each ablated area, abbreviated protocol, and standard Magnetic Resonance Imaging (MRI) studies were independently and blindly assessed in random order within and between three expert radiologists. Each radiologist assessed the ablated area by using the following categories: “LR-TR Non-viable” = 1; “LR-TR Equivocal” = 2 and “LR-TR Viable” = 0. Results: According to the concordance between MRI and Contrast enhancement ultrasound (CEUS) among 136 treated HCCs, 115 lesions were assessed as non-viable or totally ablate and 21 as viable or partially ablate. The accuracy for standard MRI protocol and abbreviated MRI protocol for predicting pathologic tumor viability of a consensus reading was 98.6% (sensitivity = 100%; specificity = 98.3%; positive predictive value = 91.3% and negative predictive value = 100%). No differences were found in sensitivity or specificity between standard MRI LR-TR viable and abbreviated MRI LR-TR viable categories (p value > 0.05 at McNemar test). Conclusion: The abbreviated dynamic protocol showed similar diagnostic accuracy to conventional MRI study in the assessment of treated HCCs, with a reduction of the acquisition study time of 30% respect to conventional MRI.

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Section: Discussionmentioning

confidence: 99%

“…Additionally, it offers cost benefits, since the contrast agents used in dynamic protocol are less expensive than the contrast agent (gadoxetate disodium) required for HEPATOBILARY-PHASE (HBP)-AMRI. The disadvantages of this approach is related to the lack of additional non-contrast sequences, which may give ancillary features [35].…”

Section: Discussionmentioning

confidence: 99%

Abbreviated MRI Protocol for the Assessment of Ablated Area in HCC Patients

Granata

Grassi

Fusco

et al. 2021

IJERPH

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“…In recent times, the use of alternate imaging strategies as part of surveillance such as the abbreviated MRI protocol (the option including non-contrast, dynamic, or hepatobiliary phase post-gadoxetate injection) has shown high sensitivity for early HCC detection approaching that of diagnostic MRI. A meta-analysis showed that the sensitivity of abbreviated MRI for detection of HCC < 2 cm was lower than that for HCC ≥ 2 cm while the sensitivity and specificity of non-contrast abbreviated MRI were comparable to contrast-enhanced abbreviated MRI [ 23 ].…”

Section: Reviewmentioning

confidence: 99%

Hepatocellular Carcinoma in 2021: An Exhaustive Update

Philips¹,

Rajesh²,

Nair³

et al. 2021

Cureus

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“…Over recent years, a range of different approaches have been investigated, including non-contrast protocols combining T2- and diffusion-weighted sequences, dynamic MRI with extracellular contrast, and abbreviated gadoxetate-enhanced hepatobiliary phase imaging [ 36 ]. In a recent systematic review comprising 15 studies (3 prospective, 12 retrospective), abbreviated MRI was found to have a higher sensitivity for HCC detection compared with ultrasound (82% vs. 53%), with comparable findings between contrast and non-contrast enhanced MRI [ 37 ]. Whilst these results are promising, MRI is contra-indicated in certain groups of patients (e.g., those with magnetic sensitive devices) and there remain concerns about its cost-effectiveness.…”

Section: Role Of Hepatocellular Carcinoma Screening In Chronic Hepatitis Bmentioning

confidence: 99%

Screening for Hepatocellular Carcinoma in Chronic Hepatitis B: An Update

Lok

Agarwal

2021

Viruses

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(1) Background: Hepatocellular carcinoma (HCC) is an important cause of mortality in individuals with chronic hepatitis B infection, with screening of high-risk groups recommended in all major international guidelines. Our understanding of the risk factors involved has improved over time, encouraging researchers to develop models that predict future risk of HCC development. (2) Methods: A literature search of the PubMed database was carried out to identify studies that derive or validate models predicting HCC development in patients with chronic hepatitis B. Subsequently, a second literature search was carried out to explore the potential role of novel viral biomarkers in this field. (3) Results: To date, a total of 23 models have been developed predicting future HCC risk, of which 12 have been derived from cohorts of treatment-naïve individuals. Most models have been developed in Asian populations (n = 20), with a smaller number in Caucasian cohorts (n = 3). All of the models demonstrate satisfactory performance in their original derivation cohorts, but many lack external validation. In recent studies, novel viral biomarkers have demonstrated utility in predicting HCC risk in patients with chronic hepatitis B, amongst both treated and treatment-naïve patients. (4) Conclusion: Several models have been developed to predict the risk of HCC development in individuals with chronic hepatitis B infection, but many have not been externally validated outside of the Asian population. Further research is needed to refine these models and facilitate a more tailored HCC surveillance programme in the future.

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Abbreviated MRI for hepatocellular carcinoma screening: A systematic review and meta-analysis

Cited by 100 publications

References 40 publications

Abbreviated MRI Protocol for the Assessment of Ablated Area in HCC Patients

Abbreviated MRI Protocol for the Assessment of Ablated Area in HCC Patients

Hepatocellular Carcinoma in 2021: An Exhaustive Update

Screening for Hepatocellular Carcinoma in Chronic Hepatitis B: An Update

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