MRI With Liver-Specific Contrast for Surveillance of Patients With Cirrhosis at High Risk of Hepatocellular Carcinoma
DC Field | Value | Language |
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dc.contributor.author | Kim, So Yeon | - |
dc.contributor.author | An, Ji hyun | - |
dc.contributor.author | Lim, Young-Suk | - |
dc.contributor.author | Han, Seungbong | - |
dc.contributor.author | Lee, Ji-Young | - |
dc.contributor.author | Byun, Jae Ho | - |
dc.contributor.author | Won, Hyung Jin | - |
dc.contributor.author | Lee, So Jung | - |
dc.contributor.author | Lee, Han Chu | - |
dc.contributor.author | Lee, Yung Sang | - |
dc.date.accessioned | 2021-07-30T05:12:16Z | - |
dc.date.available | 2021-07-30T05:12:16Z | - |
dc.date.created | 2021-05-14 | - |
dc.date.issued | 2017-04 | - |
dc.identifier.issn | 2374-2437 | - |
dc.identifier.uri | https://scholarworks.bwise.kr/hanyang/handle/2021.sw.hanyang/3546 | - |
dc.description.abstract | IMPORTANCE Current recommendations for patients with cirrhosis are to undergo surveillance for hepatocellular carcinoma (HCC) with ultrasonography (US) every 6 months. However, the sensitivity of US screening to detect early-stage HCC is suboptimal. Magnetic resonance imaging (MRI) with liver-specific contrast may detect additional HCCs missed by US in high-risk patients with cirrhosis. OBJECTIVE To compare the HCC detection rate of US and MRI in patients with cirrhosis who are at high risk for HCC. DESIGN, SETTING, AND PARTICIPANTS A prospective surveillance study of 407 patients with cirrhosis and an estimated annual risk of HCC greater than 5% who underwent 1 to 3 biannual screening examinations with paired US and liver-specific contrast-enhanced MRI at a tertiary care hospital between November 2011 and August 2014. All patients were followed-up with dynamic computed tomography (CT) at 6 months after the study. The confirmation of HCC was based on the results of histologic examination and/or typical CT images of HCC. MAIN OUTCOMES AND MEASURES HCC detection rates and false-positive findings of US vs MRI. RESULTS A total of 407 eligible patients received 1100 screenings with paired US and MRI. Hepatocellular carcinomas were diagnosed in 43 patients: 1 detected by US only, 26 by MRI only, 11 by both, and 5 were missed by both. The HCC detection rate of MRI was 86.0% (37/43), significantly higher than the 27.9%(12/43) of US (P <.001). Magnetic resonance imaging showed a significantly lower rate of false-positive findings than US (3.0% vs 5.6%; P =.004). Of the 43 patients with HCC, 32 (74.4%) had very early-stage HCC (a single nodule <2 cm), and 29 (67.4%) received curative treatments. The 3-year survival rate of the patients with HCC (86.0%) was not inferior to those without HCC (94.2%; hazard ratio, 2.26; 95% CI, 0.92-5.56; P =.08). CONCLUSIONS AND RELEVANCE In patients with cirrhosis at high-risk of HCC, screening that used MRI with liver-specific contrast resulted in a higher HCC detection rate and lower false-positive findings compared with US. With MRI screening, most of the cancers detected were at very early stage, which was associated with a high chance of curative treatments and favorable survival of patients. Whether surveillance with MRI would reduce mortality from HCC in high-risk patients requires further investigation. | - |
dc.language | 영어 | - |
dc.language.iso | en | - |
dc.publisher | AMER MEDICAL ASSOC | - |
dc.title | MRI With Liver-Specific Contrast for Surveillance of Patients With Cirrhosis at High Risk of Hepatocellular Carcinoma | - |
dc.type | Article | - |
dc.contributor.affiliatedAuthor | An, Ji hyun | - |
dc.identifier.doi | 10.1001/jamaoncol.2016.3147 | - |
dc.identifier.scopusid | 2-s2.0-85018566447 | - |
dc.identifier.wosid | 000399425800007 | - |
dc.identifier.bibliographicCitation | JAMA ONCOLOGY, v.3, no.4, pp.456 - 463 | - |
dc.relation.isPartOf | JAMA ONCOLOGY | - |
dc.citation.title | JAMA ONCOLOGY | - |
dc.citation.volume | 3 | - |
dc.citation.number | 4 | - |
dc.citation.startPage | 456 | - |
dc.citation.endPage | 463 | - |
dc.type.rims | ART | - |
dc.type.docType | 정기학술지(Article(Perspective Article포함)) | - |
dc.description.journalClass | 1 | - |
dc.description.isOpenAccess | Y | - |
dc.description.journalRegisteredClass | scie | - |
dc.description.journalRegisteredClass | scopus | - |
dc.relation.journalResearchArea | Oncology | - |
dc.relation.journalWebOfScienceCategory | Oncology | - |
dc.subject.keywordPlus | ULTRASOUND | - |
dc.subject.keywordPlus | EFFICACY | - |
dc.subject.keywordPlus | CT | - |
dc.identifier.url | https://jamanetwork.com/journals/jamaoncology/fullarticle/2553752 | - |
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