2017
DOI: 10.1111/apt.13910
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Editorial: ultrasound surveillance of hepatocellular carcinoma in the 21st century - authors' reply

Abstract: implications, given the relative limited capacity of these modalities compared to ultrasound in most societies. Neither modality is without risk. CT involves significant radiation doses and both CT and MRI require the administration of intravenous contrast for optimum examination which can be associated with significant side effects. 7Despite its limitations, ultrasound will remain the primary imaging modality for HCC for the foreseeable future. It is therefore crucial to maximise the performance of ultrasound… Show more

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Cited by 3 publications
(3 citation statements)
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“…Unlike hepatitis C, B and alcohol, NAFLD HCC screening has several challenges. Obesity, common in this patient population, has been shown to decrease the effectiveness of ultrasound screening [127][128][129] . The effects of visceral adipose tissue or intrahepatic steatosis in lesions are also unclear.…”
Section: Screening?mentioning
confidence: 99%
“…Unlike hepatitis C, B and alcohol, NAFLD HCC screening has several challenges. Obesity, common in this patient population, has been shown to decrease the effectiveness of ultrasound screening [127][128][129] . The effects of visceral adipose tissue or intrahepatic steatosis in lesions are also unclear.…”
Section: Screening?mentioning
confidence: 99%
“…The American Association for the Study of Liver Diseases recommends surveillance with abdominal ultrasound with or without α-fetoprotein (AFP) measurement every 6 months in all patients with cirrhosis and in certain patients with chronic HBV infection [16]. Ultrasounds, aside from being inconvenient and time consuming, have numerous limitations included limited sensitivity in patients with central obesity, ascites or cirrhosis and can suffer from interobserver variability in quality, therefore better risk stratification and screening methods for HCC detection are needed [17][18][19][20]. The inclusion of AFP in surveillance protocols is controversial due to concerns about specificity leading to false-positives and limited sensitivity in early detection, thus there are varying guidelines as to the optimal approach for surveillance [10,16,21].…”
Section: Practice Pointsmentioning
confidence: 99%
“…Clinicians have developed adequate screening [102] . Finally, it is important to underline that ultrasonography (US) is likely inadequate in several subgroups of patients (obese, Child Pugh B or C, alcohol and NASH related cirrhotic) and does not permit the exclusion of the presence of HCC [103] .…”
Section: Hcc In Nafld Cirrhosismentioning
confidence: 99%