J Liver Cancer.  2020 Mar;20(1):25-31. 10.17998/jlc.20.1.25.

Liver Magnetic Resonance Imaging for Hepatocellular Carcinoma Surveillance

• Park SH
• Kim B

• KMID: 2505839
• DOI: http://doi.org/10.17998/jlc.20.1.25

Abstract

Hepatocellular carcinoma (HCC) surveillance is recommended when the annual incidence of HCC exceeds 1.5%. In 2018, several international guidelines included alternative surveillance modalities, such as computed tomography and magnetic resonance imaging (MRI), as alternatives for patients with inadequate surveillance with an ultrasound. Currently, abbreviated MRI selectively includes several key sequences and is emerging as an effective tool for HCC surveillance with reduced cost and scan time and the required diagnostic performance. The incidence of HCC substantially impacts the benefits of surveillance in terms of cost-effectiveness. Therefore, we need to individualize imaging surveillance of HCC, tailor screening, and determine risk-stratified strategies. The purpose of this article was to present a brief overview of the diagnostic performance and cost-effectiveness of liver MRI as an HCC surveillance tool.

Keyword

Hepatocellular carcinoma; Liver; Magnetic resonance imaging; Surveillance

Figure

• 

  Figure 1. Guidelines in 2018 on alternative surveillance modalities. HCC, hepatocellular carcinoma; EASL, European Association for the Study of the Liver; US, ultrasonography; CT, computed tomography; MRI, magnetic resonance imaging; AASLD, American Association for the Study of Liver Diseases; AFP, alpha fetoprotein; NAFLD, non-alcoholic fatty liver disease; KLCA & NCC, Korean Liver Cancer Association-National Cancer Center Korea.

• 

  Figure 2. A representative case of hepatocellular carcinoma in a treatment-naive 60-year-old woman with hepatitis B-associated cirrhosis. Abbreviated magnetic resonance imaging shows a 1.3 cm, positive nodule (arrows) for hepatocellular carcinoma in segment 5. The lesion shows (A) mild high signal intensity on T2-weighted image, (B) diffusion restriction, and (C, D) fat-containing lesion on T1-weighted dual gradient-echo in-phase and out-of-phase images.

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