Improving HCC Surveillance with abbreviated MRI: A Call to Integrate and Innovate?

Hepatocellular carcinoma (HCC) remains a formidable challenge in oncology, largely due to its asymptomatic nature in early stages and poor prognosis once advanced. Despite limited evidence, current recommendations for the surveillance of HCC are based on semiannual liver ultrasound (with or without serum alpha fetoprotein) in patients with high risk of liver cancer, i.e., mostly cirrhosis and subgroups with chronic hepatitis B infection (1-3). However, the sensitivity of this strategy is suboptimal for the detection of HCC at the earliest possible stage. The use of ultrasound has been challenged by several metanalyses (4,5) or prospective follow-up studies reporting on a poor sensitivity for the detection of very early-stage HCC. Several factors have been proposed to explain this suboptimal performance, including the difficult liver visualization in obese and/or MASLD patients, a nodular appearance in a subset of cirrhotic livers, the skills and expertise of the operators, and poor adherence to surveillance programs.
Source: Journal of Hepatology - Category: Gastroenterology Authors: Tags: Editorial Source Type: research