Comparative efficacy of an optimal exam between ultrasound versus abbreviated MRI for HCC screening in NAFLD cirrhosis: A prospective study

作者：Daniel Q. Huang, Kathryn J. Fowler, Joy Liau, Guilherme Moura Cunha, Ashley L. Louie, Julie Y. An, Ricki Bettencourt, Jinho Jung, Zachary Gitto, Christie Hernandez, Scarlett Lopez, Hersh Gupta, Claude B. Sirlin, Robert M. Marks, Rohit Loomba · 发表于：Alimentary Pharmacology & Therapeutics · 年份：2022 · DOI：10.1111/apt.16844 · 被引用次数：56 · 研究领域：Liver Disease Diagnosis and Treatment、Hepatocellular Carcinoma Treatment and Prognosis、Liver Disease and Transplantation

BACKGROUND: Retrospective studies report that visualisation of the liver may be severely limited using ultrasound (US), potentially contributing to diminished sensitivity for detection of hepatocellular carcinoma (HCC) among patients with nonalcoholic fatty liver disease (NAFLD) and cirrhosis, but there are limited prospective data. AIMS: To compare liver visualisation scores prospectively for US and abbreviated hepatobiliary phase (HBP) magnetic resonance imaging (AMRI) in a cohort of participants with NAFLD cirrhosis and a clinical indication for HCC surveillance. METHODS: This prospective multicenter study included 54 consecutive participants (67% women) with NAFLD cirrhosis who underwent contemporaneous US as well as HBP-AMRI with gadoxetic acid. Primary outcome was the proportion of imaging examinations with severe limitations in liver visualisation (visualisation score C) compared head-to-head between US and AMRI. RESULTS: (±6.0). Nineteen participants (35%) had severe visualisation limitations on US, compared with 10 (19%) with AMRI, p < 0.0001. Nine (17%) participants had <90% of the liver visualised on US, compared with only 1 (2%) participant with AMRI, p < 0.0001. Obesity was a strong and independent predictor for severe visualisation limitation on US (OR 5.1, CI 1.1-23.1, p = 0.03), after adjustment for age, sex and ethnicity. CONCLUSION: More than one-third of participants with NAFLD cirrhosis had severe visualisation limitations on US for HCC screening, compared...