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Abstract Details
Alternative approach of hepatocellular carcinoma surveillance: abbreviated MRI
Ryan L Brunsing1, Kathryn J Fowler2, Takeshi Yokoo3, Guilherme Moura Cunha2, Claude B Sirlin2, Robert M Marks45
Author information
1Department of Radiology, Stanford University, Stanford, CA 94305, USA.
2Liver Imaging Group, Department of Radiology, University of California San Diego, San Diego, CA 92093, USA.
3Department of Radiology, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA.
4Department of Radiology, Naval Medical Center San Diego, San Diego, CA 92134, USA.
5Department of Radiology, Uniformed Services University of the Health Sciences, Bethesda, MD 20892, USA.
Abstract
This review focuses on emerging abbreviated magnetic resonance imaging (AMRI) surveillance of patients with chronic liver disease for hepatocellular carcinoma (HCC). This surveillance strategy has been proposed as a high-sensitivity alternative to ultrasound for identification of patients with early-stage HCC, particularly in patients with cirrhosis or obesity, in whom sonographic visualization of small tumors may be compromised. Three general AMRI approaches have been developed and studied in the literature - non-contrast AMRI, dynamic contrast-enhanced AMRI, and hepatobiliary phase contrast-enhanced AMRI - each comprising a small number of selected sequences specifically tailored for HCC detection. The rationale, general technique, advantages and disadvantages, and diagnostic performance of each AMRI approach is explained. Additionally, current gaps in knowledge and future directions are discussed. Based on emerging evidence, we cautiously recommend the use of AMRI for HCC surveillance in situations where ultrasound is compromised.