Gadoxetate-enhanced Abbreviated MRI for Hepatocellular Carcinoma Surveillance: Preliminary Experience

Alternative approach of hepatocellular carcinoma surveillance: abbreviated MRI

“…There is no need for image acquisition timing, and images compromised by respiratory or other motion artefacts can simply be repeated. It also eliminates any GBCA-associated risks, including rare but potentially serious adverse reactions [ 31 ] , theoretical concerns about gadolinium deposition in the brain [ 44 , 45 ] , and the remote possibility of nephrogenic systemic sclerosis, a disorder unique to patients with acute kidney injury or severely compromised renal function receiving high doses of certain GBCAs [ 46 ] .…”

“…However, a small number of incident HCCs ( n = 6) and low prevalence of Child Pugh status B or C cirrhosis (< 6%) limit the generalizability of this result. To our knowledge, this study and a HBP-AMRI study discussed below [ 31 ] are the only two studies to-date evaluating the performance of AMRI interpreted prospectively in the clinical setting.…”

“…Positive examinations prompt call back for diagnostic MRI or CT. The scoring of HBP-AMRI has been reported previously [ 31 ] , with an example provided in Figure 5 .…”

“…These studies have reported per-patient sensitivities in the range of 80%-83%, per-patient specificities in the range of 93%-96%, and a per-lesion sensitivity of 85%. One study evaluated the performance of HBP-AMRI interpreted prospectively in an HCC surveillance population, demonstrating a sensitivity of 91% and sensitivity of 99% [ 31 ] . In this study, 20% of patients had Child Pugh B or C cirrhosis with 12 HCC in the cohort.…”

“…Motivated to provide higher sensitivity than US while avoiding the limitations of CT and conventional MRI, investigators have developed abbreviated MRI (AMRI) protocols that rely on a small number of select sequences specifically tailored for HCC detection [12,[23][24][25][26][27][28][29][30][31][32][33][34][35][36] . The rationale is that reduced scanner time decreases costs and complexity, while improving patient comfort, without significantly compromising HCC detection.…”