Evaluation of Hepatocellular Carcinoma Surveillance with Contrast-enhanced MRI in a High-Risk Western European Cohort.

Autor: Fiduzi FIF; Department of Radiology & Nuclear Medicine, Erasmus Medical Center, Dr. Molewaterplein 40, 3015GD, Rotterdam, The Netherlands., Willemssen FEJA; Department of Radiology & Nuclear Medicine, Erasmus Medical Center, Dr. Molewaterplein 40, 3015GD, Rotterdam, The Netherlands., de Braak CV; Department of Radiology & Nuclear Medicine, Erasmus Medical Center, Dr. Molewaterplein 40, 3015GD, Rotterdam, The Netherlands., de Lussanet de la Sablonière QG; Department of Radiology & Nuclear Medicine, Erasmus Medical Center, Dr. Molewaterplein 40, 3015GD, Rotterdam, The Netherlands., IJzermans JNM; Department of Surgery, Erasmus Medical Center, Rotterdam, The Netherlands., Bos D; Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands., de Man RA; Department of Hepatology, Erasmus Medical Center, Rotterdam, The Netherlands., Dwarkasing RS; Department of Radiology & Nuclear Medicine, Erasmus Medical Center, Dr. Molewaterplein 40, 3015GD, Rotterdam, The Netherlands. Electronic address: r.s.dwarkasing@erasmusmc.nl.
Jazyk: angličtina
Zdroj: Current problems in diagnostic radiology [Curr Probl Diagn Radiol] 2024 Nov-Dec; Vol. 53 (6), pp. 709-716. Date of Electronic Publication: 2024 Jul 09.
DOI: 10.1067/j.cpradiol.2024.07.001
Abstrakt: Aim: To investigate the utilization of MRI using a MRI liver protocol with extracellular contrast-enhanced series for hepatocellular carcinoma (HCC) surveillance in high-risk patients.
Methods: Consecutive high-risk patients of a western European cohort who underwent repeated liver MRI for HCC screening were included. Lesions were registered according to the Liver Reporting & Data System (LIRADS) 2018. HCC was staged as very early stage HCC (BCLC stage 0) and more advanced stages of HCC (BCLC stage A-D). Differences in time interval between MRI's for BCLC stage 0 and stage A-D were calculated with the Mann-Whitney U test. The HCC cumulative incidence at one-, three- and five years was calculated with the Kaplan Meier estimator.
Results: From 2010 to 2019 a total of 240 patients were included (71% male; median age: 57 years; IQR: 50-64 years) with 1350 MRI's. Most patients (83 %) had cirrhosis with hepatitis C as the most common underlying cause. Patients underwent on average four MRI's (IQR: 3-7). Forty-two patients (17.5%) developed HCC (52 HCC lesions: 43 LIRADS-5, eight LIRADS-4, and one LIRADS-TIV). Eighteen patients (43%) had BCLC stage 0 HCC with a significant shorter screening time interval (10 months; IQR: 6-21) compared to patients with BCLC stage A-D (21 months; IQR: 10-32) (p = 0.03). Thirty seven percent of patients with a LIRADS-3 lesion (n=43) showed HCC development within twelve months (median: 7.4 months). One, three- and five-year HCC cumulative incidence in cirrhotic patients was 1%, 10% and 17%, respectively.
Conclusion: High-risk patients who underwent surveillance with contrast-enhanced MRI developed HCC in 17.5 % during a follow up period of over 4 years median. Very early stage HCC was seen in compensated cirrhosis after a median time interval of 10 months. Later stages of HCC were related to prolonged screening time interval (median 21 months).
Competing Interests: Declaration of competing interest All authors have read and approved the manuscript and no conflicts of interest exist.
(Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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