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MRI is the most commonly used imaging modality for HCC screening at a tertiary care transplant center

  • Hepatobiliary
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Abstract

Purpose

In this study, we describe the patterns of hepatocellular carcinoma (HCC) screening with imaging and factors associated with imaging modality selection in a tertiary care transplant center.

Methods

This was a retrospective study where all adult patients with cirrhosis and/or chronic hepatitis B virus infection referred for HCC screening with ultrasound (US), CT or MRI were identified during 2017. The association between imaging methods, demographic/clinical data were analyzed by uni- and multivariate analysis.

Results

A total of 1437 patients were included (median age 61y, 59% male, median BMI 27.5 kg/m2, median AFP 3.4 ng/mL, 37% with HCV and 87% with cirrhosis). Index screening imaging method utilization included MRI (51%), US (33%) and CT (16%). Use of US as the index imaging modality for screening was significantly associated with race/ethnicity [Odds Ratio (OR) 1.71–2.01, all p < 0.05] in multivariate analysis. Presence of cirrhosis (OR 0.29, p < 0.001) and referral by a hepatologist (OR 0.23, p < 0.001) were associated with screening with MRI in the multivariate analysis; while gender, age, BMI, etiology and income at ZIP code of residence were not significantly associated with imaging modality selection. HCC was observed in 62 patients (prevalence 4.3%). Rate of HCC detection was significantly higher with MRI vs US (5.9% vs. 1.5%, p = 0.001).

Conclusion

MRI was the most frequently used modality (> 50%) for HCC screening in our tertiary care center, in contrast with the current practice guidelines. Race/ethnicity, cirrhosis and referral by a hepatologist were associated with the imaging method used for HCC screening.

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Data availability

All data is available for review.

Change history

  • 06 December 2021

    The co-author “Naik Vietti Violi” family name has been incorrectly tagged in the xml. However it is now corrected.

Abbreviations

AASLD:

American Association for the Study of Liver Diseases

AFP:

Alpha fetoprotein

BMI:

Body Mass Index

CT:

Computed Tomography

EASL:

European Association for the study of the Liver

HBV:

Hepatitis B virus

HCC:

Hepatocellular carcinoma

HCV:

Hepatitis C virus

IQR:

Interquartile range

LI-RADS:

Liver Reporting and Data System

MRI:

Magnetic Resonance Imaging

OR:

Odds Ratio

UNOS:

United Network for Organ Sharing

US:

Ultrasound

USA:

United States of America

ZIP:

Zone Improvement Plan

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Authors and Affiliations

  1. Department of Diagnostic, Molecular and Interventional Radiology, Icahn School of Medicine at Mount Sinai (ISMMS), 1470 Madison Avenue, New York, NY, 10029, USA

    Gabriela Hernandez-Meza, Dillan Villavisanis, Samuel Z. Maron, Justin Frere & Bachir Taouli

  2. BioMedical Engineering and Imaging Institute, ISMMS, 1470 Madison Avenue, New York, NY, 10029, USA

    Gabriela Hernandez-Meza, Naik Vietti Violi, Daniela Said, Dillan Villavisanis, Samuel Z. Maron, Justin Frere & Bachir Taouli

  3. Department of Radiology, Lausanne University Hospital, Lausanne, Switzerland

    Naik Vietti Violi

  4. Department of Radiology, Universidad de los Andes, Santiago, Chile

    Daniela Said

  5. Department of Radiology, Albert Einstein College of Medicine, New York, NY, USA

    Eitan Novogrodsky

  6. Recanati/Miller Transplantation Institute, ISMMS, New York, NY, USA

    Thomas D. Schiano

  7. Division of Liver Diseases, ISMMS, New York, NY, USA

    Scott Friedman & Andrea Branch

  8. Tisch Cancer Institute, ISMMS, New York, NY, USA

    Paolo Boffetta

  9. Department of Family, Population & Preventive Medicine, Renaissance School of Medicine, Stony Brook, NY, USA

    Paolo Boffetta

Authors
  1. Gabriela Hernandez-Meza
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  2. Naik Vietti Violi
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  3. Daniela Said
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  4. Eitan Novogrodsky
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  5. Dillan Villavisanis
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  6. Samuel Z. Maron
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  7. Justin Frere
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  8. Thomas D. Schiano
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  9. Scott Friedman
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  10. Paolo Boffetta
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  11. Andrea Branch
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  12. Bachir Taouli
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Contributions

GHM, NVV and BT—study concept and design, data analysis, writing. EN, DV, SZM, JF—data collection and proofing. TDS, PB, SF, AB—writing and proofing.

Corresponding author

Correspondence to Bachir Taouli.

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Conflict of interest

BT: consultancy and/or advisory roles for Bayer, Helio Health; Research funding/support: Bayer, Takeda, Regeneron, Echosens.

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Hernandez-Meza, G., Vietti Violi, N., Said, D. et al. MRI is the most commonly used imaging modality for HCC screening at a tertiary care transplant center. Abdom Radiol 46, 5142–5151 (2021). https://doi.org/10.1007/s00261-021-03212-7

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