All international guidelines recommend 6-monthly ultrasound surveillance for patients at risk for liver cancer (hepatocellular carcinoma or HCC), such as patients with cirrhosis. The aim of surveillance is to detect HCC at an early stage when it is still potentially curable. Currently only 4 out of 10 HCCs are detected at the early stage. Ultrasound surveillance for HCC has a wide ranging sensitivity, dependent on many factors such as operator experience, patient body habitus and liver parenchymal heterogeneity due to chronic liver disease and cirrhosis. In a select group of patients, surveillance ultrasound can be suboptimal or near non-diagnostic. Currently no guideline offers an alternative surveillance tool for patients who have suboptimal surveillance ultrasounds.
The investigators plan to conduct a prospective study to examine the diagnostic performance of abbreviated non-contrast MRI (aNC-MRI) versus ultrasound, in a select group of cirrhotic patients with poor ultrasound visualisation.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
SCREENING
Masking
NONE
Enrollment
476
every 6 months
every 6 months
screening
Royal Prince Alfred Hospital
Camperdown, New South Wales, Australia
NOT_YET_RECRUITINGConcord Repatriation General Hospital
Concord, New South Wales, Australia
RECRUITINGGosford Hospital
Gosford, New South Wales, Australia
NOT_YET_RECRUITINGPrince of Wales Hospital
Randwick, New South Wales, Australia
NOT_YET_RECRUITINGWestmead Hospital
Westmead, New South Wales, Australia
NOT_YET_RECRUITINGPrincess Alexandra Hospital
Brisbane, Queensland, Australia
NOT_YET_RECRUITINGSt Vincent's Hospital Melbourne
Fitzroy, Victoria, Australia
NOT_YET_RECRUITINGAustin Hospital
Heidelberg, Victoria, Australia
NOT_YET_RECRUITINGRoyal Perth Hospital
Perth, Western Australia, Australia
NOT_YET_RECRUITINGNorth Shore Hospital
Takapuna, Auckland, New Zealand
NOT_YET_RECRUITINGHCC detection with US surveillance versus aNC-MRI surveillance
The detection of hepatic malignancy on the two modalities will be compared * Sensitivity, specificity, PPV and NPV of HCC detection with US surveillance vs aNC-MRI surveillance * Correlation with diagnostic imaging (multiphase CT or MRI) and/or histopathology as a reference standard For the diagnosis of HCC we will accept * Imaging diagnosis based on the Liver Imaging Reporting and Data System (LI-RADS) * Any pathological proof on biopsy or excision The HCC will then be staged based on the Barcelona clinic liver cancer (BCLC) staging system For the diagnosis of non-HCC hepatic malignancy we will accept * Imaging diagnosis based on the Liver Imaging Reporting and Data System (LI-RADS) * Any pathological proof on biopsy or excision
Time frame: 3 or 5 years
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