Non-contrast short MRI surveillance for HCC screening: the study protocol of the SMS-HCC prospective multicenter study
Abstract Hepatocellular carcinoma (HCC) comprises 75 to 85% of all primary liver cancers. Current guidelines recommend a biannual HCC surveillance using ultrasound (US) for high-risk patients. However, due to its low sensitivity for detection of early-stage HCC lesions, there is an urgency for more...
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
SpringerOpen
2024-03-01
|
| Series: | European Radiology Experimental |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s41747-024-00432-6 |
| _version_ | 1797259506559746048 |
|---|---|
| author | Céline van de Braak François E. J. A. Willemssen Rob A. de Man Aad van der Lugt Carin A. Uyl-de Groot Daniel Bos Roy S. Dwarkasing |
| author_facet | Céline van de Braak François E. J. A. Willemssen Rob A. de Man Aad van der Lugt Carin A. Uyl-de Groot Daniel Bos Roy S. Dwarkasing |
| author_sort | Céline van de Braak |
| collection | DOAJ |
| description | Abstract Hepatocellular carcinoma (HCC) comprises 75 to 85% of all primary liver cancers. Current guidelines recommend a biannual HCC surveillance using ultrasound (US) for high-risk patients. However, due to its low sensitivity for detection of early-stage HCC lesions, there is an urgency for more sensitive surveillance tools. Here, we describe the potential of a short MRI surveillance (SMS) protocol for HCC, including axial T1-weighted in-out phase, fat-saturated T2-weighted, and diffusion-weighted sequences. In this prospective, multicenter, patient cohort study, patients will be recruited from existing HCC surveillance cohorts of six medical centers in The Netherlands. Surveillance patients who undergo biannual US, will be invited for SMS on the same day for 3 years. In case of a suspicious finding on either US or SMS, patients will be invited for a full MRI liver protocol including gadolinium-based contrast agent intravenous injection within 2 weeks. To our knowledge, this will be the first study to perform a head-to-head comparison with a paired US-MRI design. We hypothesize that the sensitivity of SMS for detection of early-stage HCC will be higher than that of US leading to improved survival of surveillance patients through timely HCC diagnosis. Furthermore, we hypothesize that the SMS-HCC protocol will prove cost-effective. Relevance statement The US sensitivity for detecting early-stage HCC has been reported to be less than 50%. We expect that the proposed SMS will detect at least twice as many early-stage HCC lesions and therefore prove to be cost-effective. Key points • The low sensitivity of US necessitates better imaging tools for HCC screening. • This is the first study with a paired US-MRI design. • This design will allow a head-to-head comparison in both diagnostics and patient-acceptance. • We expect that SMS can contribute to a higher survival rate. Graphical Abstract |
| first_indexed | 2024-04-24T23:10:31Z |
| format | Article |
| id | doaj.art-748fc83f9deb456d9dfe231f52fc62a8 |
| institution | Directory Open Access Journal |
| issn | 2509-9280 |
| language | English |
| last_indexed | 2024-04-24T23:10:31Z |
| publishDate | 2024-03-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | European Radiology Experimental |
| spelling | doaj.art-748fc83f9deb456d9dfe231f52fc62a82024-03-17T12:14:02ZengSpringerOpenEuropean Radiology Experimental2509-92802024-03-01811810.1186/s41747-024-00432-6Non-contrast short MRI surveillance for HCC screening: the study protocol of the SMS-HCC prospective multicenter studyCéline van de Braak0François E. J. A. Willemssen1Rob A. de Man2Aad van der Lugt3Carin A. Uyl-de Groot4Daniel Bos5Roy S. Dwarkasing6Department of Radiology & Nuclear Medicine, Erasmus Medical CenterDepartment of Radiology & Nuclear Medicine, Erasmus Medical CenterDepartment of Hepatology, Erasmus Medical CenterDepartment of Radiology & Nuclear Medicine, Erasmus Medical CenterErasmus School of Health Policy & Management and Institute for Medical Technology Assessment, Erasmus University RotterdamDepartment of Radiology & Nuclear Medicine, Erasmus Medical CenterDepartment of Radiology & Nuclear Medicine, Erasmus Medical CenterAbstract Hepatocellular carcinoma (HCC) comprises 75 to 85% of all primary liver cancers. Current guidelines recommend a biannual HCC surveillance using ultrasound (US) for high-risk patients. However, due to its low sensitivity for detection of early-stage HCC lesions, there is an urgency for more sensitive surveillance tools. Here, we describe the potential of a short MRI surveillance (SMS) protocol for HCC, including axial T1-weighted in-out phase, fat-saturated T2-weighted, and diffusion-weighted sequences. In this prospective, multicenter, patient cohort study, patients will be recruited from existing HCC surveillance cohorts of six medical centers in The Netherlands. Surveillance patients who undergo biannual US, will be invited for SMS on the same day for 3 years. In case of a suspicious finding on either US or SMS, patients will be invited for a full MRI liver protocol including gadolinium-based contrast agent intravenous injection within 2 weeks. To our knowledge, this will be the first study to perform a head-to-head comparison with a paired US-MRI design. We hypothesize that the sensitivity of SMS for detection of early-stage HCC will be higher than that of US leading to improved survival of surveillance patients through timely HCC diagnosis. Furthermore, we hypothesize that the SMS-HCC protocol will prove cost-effective. Relevance statement The US sensitivity for detecting early-stage HCC has been reported to be less than 50%. We expect that the proposed SMS will detect at least twice as many early-stage HCC lesions and therefore prove to be cost-effective. Key points • The low sensitivity of US necessitates better imaging tools for HCC screening. • This is the first study with a paired US-MRI design. • This design will allow a head-to-head comparison in both diagnostics and patient-acceptance. • We expect that SMS can contribute to a higher survival rate. Graphical Abstracthttps://doi.org/10.1186/s41747-024-00432-6HepatitisHepatocellular carcinomaLiver cirrhosisMagnetic resonance imagingUltrasonography |
| spellingShingle | Céline van de Braak François E. J. A. Willemssen Rob A. de Man Aad van der Lugt Carin A. Uyl-de Groot Daniel Bos Roy S. Dwarkasing Non-contrast short MRI surveillance for HCC screening: the study protocol of the SMS-HCC prospective multicenter study European Radiology Experimental Hepatitis Hepatocellular carcinoma Liver cirrhosis Magnetic resonance imaging Ultrasonography |
| title | Non-contrast short MRI surveillance for HCC screening: the study protocol of the SMS-HCC prospective multicenter study |
| title_full | Non-contrast short MRI surveillance for HCC screening: the study protocol of the SMS-HCC prospective multicenter study |
| title_fullStr | Non-contrast short MRI surveillance for HCC screening: the study protocol of the SMS-HCC prospective multicenter study |
| title_full_unstemmed | Non-contrast short MRI surveillance for HCC screening: the study protocol of the SMS-HCC prospective multicenter study |
| title_short | Non-contrast short MRI surveillance for HCC screening: the study protocol of the SMS-HCC prospective multicenter study |
| title_sort | non contrast short mri surveillance for hcc screening the study protocol of the sms hcc prospective multicenter study |
| topic | Hepatitis Hepatocellular carcinoma Liver cirrhosis Magnetic resonance imaging Ultrasonography |
| url | https://doi.org/10.1186/s41747-024-00432-6 |
| work_keys_str_mv | AT celinevandebraak noncontrastshortmrisurveillanceforhccscreeningthestudyprotocolofthesmshccprospectivemulticenterstudy AT francoisejawillemssen noncontrastshortmrisurveillanceforhccscreeningthestudyprotocolofthesmshccprospectivemulticenterstudy AT robademan noncontrastshortmrisurveillanceforhccscreeningthestudyprotocolofthesmshccprospectivemulticenterstudy AT aadvanderlugt noncontrastshortmrisurveillanceforhccscreeningthestudyprotocolofthesmshccprospectivemulticenterstudy AT carinauyldegroot noncontrastshortmrisurveillanceforhccscreeningthestudyprotocolofthesmshccprospectivemulticenterstudy AT danielbos noncontrastshortmrisurveillanceforhccscreeningthestudyprotocolofthesmshccprospectivemulticenterstudy AT roysdwarkasing noncontrastshortmrisurveillanceforhccscreeningthestudyprotocolofthesmshccprospectivemulticenterstudy |