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Magnetic Resonance Imaging-Based Surveillance of Hepatocellular Carcinoma: Current Status and Future Perspectives

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Abstract

Purpose of Review

We aimed to introduce various magnetic resonance imaging (MRI)-based hepatocellular carcinoma (HCC) surveillance strategies in high-risk patients from technical to clinical viewpoints and provide guidance on selecting patients who would benefit from MRI-based surveillance.

Recent Findings

MRI has recently gained attention as an HCC surveillance tool due to its superior sensitivity in detecting early-stage HCC over ultrasonography (US). However, complete-sequence contrast-enhanced liver MRI has limitations of long scan time and high cost. Abbreviated MRI (AMRI) utilizes only the essential sequences for detecting HCC and has gained popularity for reduced scan time and cost while maintaining high diagnostic performance. Three AMRI protocols have been proposed, including hepatobiliary-phase, dynamic contrast-enhanced, and non-enhanced AMRI. Herein, technical details, result interpretation, performances based on previous work, ongoing trials, and current issues regarding each MRI protocol are discussed. For maximum benefits of MRI-based surveillance, a risk-stratified approach should be undertaken to select the target population, simultaneously considering cost-effectiveness. MRI-based HCC surveillance can be beneficial for populations whose US examination has inadequate quality. Evidence of cost-effectiveness of MRI-based surveillance for high-risk patients is growing.

Summary

MRI-based surveillance, particularly using AMRI, shows promise as a sensitive and cost-effective approach for early detection of HCC. Tailored approaches that take into account the patient’s HCC risk and the quality of ultrasonographic images can optimize the benefits of MRI-based surveillance. Further research is needed to assess the cost-effectiveness of MRI-based surveillance strategies.

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Data Availability

Data sharing is not applicable to this article as no data sets were generated or analyzed during the current study.

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Author notes

  1. So Yeon Kim and Young-Suk Lim contributed equally to this work as co-corresponding authors.

Authors and Affiliations

  1. Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Republic of Korea

    Hyo Jung Park & So Yeon Kim

  2. Liver Cancer Center, Asan Medical Center, Seoul, Republic of Korea

    So Yeon Kim & Young-Suk Lim

  3. Department of Gastroenterology, Liver Center, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Republic of Korea

    Young-Suk Lim

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H.J.P., as the first author, wrote the main manuscript text and prepared tables and figures. S.Y.K. and Y.S.L., as co-corresponding authors, reviewed and revised the manuscript.

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Correspondence to So Yeon Kim or Young-Suk Lim.

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Y.S.L. received grant from Gilead Sciences, has been a consultant for AbbVie, Assembly Biosciences, GlaxoSmithKline, Gilead Sciences, Janssen, Olix Pharmaceuticals, Roche, Vaccitech, and Vir Biotechnology, and received speaker fees from AbbVie, Gilead Sciences, and Vaccitech. The remaining authors have no financial disclosures.

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Park, H.J., Kim, S.Y. & Lim, YS. Magnetic Resonance Imaging-Based Surveillance of Hepatocellular Carcinoma: Current Status and Future Perspectives. Curr Hepatology Rep 22, 83–94 (2023). https://doi.org/10.1007/s11901-023-00611-w

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