MRI is the most commonly used imaging modality for HCC screening at a tertiary care transplant center

• DOI: 10.1007/s00261-021-03212-7
• Publication Date: 2021-07-20T08:02:57Z
• Authors: Gabriela Hernande...; Naik Vietti Violi; Daniela Said; Eitan Novogrodsky; Dillan Villavisanis; Samuel Z. Maron; Justin Frere; Thomas D. Schiano; Scott Friedman; Paolo Boffetta; Andrea Branch; Bachir Taouli
• Keywords: Adult; Liver Cirrhosis; Male; 0301 basic medicine; Carcinoma, Hepatocellular; Tertiary Healthcare; Liver Neoplasms; Middle Aged; Magnetic Resonance Imaging; Hepatocellular carcinoma; Magnetic Resonance Imaging; Screening; Ultrasonography; Adult; Female; Humans; Liver Cirrhosis; Magnetic Resonance Imaging; Male; Middle Aged; Retrospective Studies; Tertiary Care Centers; Tertiary Healthcare; alpha-Fetoproteins; Carcinoma, Hepatocellular; Hepatitis B, Chronic; Liver Neoplasms; 3. Good health; Tertiary Care Centers; 03 medical and health sciences; Hepatitis B, Chronic; Humans; Female; alpha-Fetoproteins; Retrospective Studies

In this study, we describe the patterns of hepatocellular carcinoma (HCC) screening with imaging and factors associated with imaging modality selection in a tertiary care transplant center.This was a retrospective study where all adult patients with cirrhosis and/or chronic hepatitis B virus infection referred for HCC screening with ultrasound (US), CT or MRI were identified during 2017. The association between imaging methods, demographic/clinical data were analyzed by uni- and multivariate analysis.A total of 1437 patients were included (median age 61y, 59% male, median BMI 27.5 kg/m2, median AFP 3.4 ng/mL, 37% with HCV and 87% with cirrhosis). Index screening imaging method utilization included MRI (51%), US (33%) and CT (16%). Use of US as the index imaging modality for screening was significantly associated with race/ethnicity [Odds Ratio (OR) 1.71-2.01, all p < 0.05] in multivariate analysis. Presence of cirrhosis (OR 0.29, p < 0.001) and referral by a hepatologist (OR 0.23, p < 0.001) were associated with screening with MRI in the multivariate analysis; while gender, age, BMI, etiology and income at ZIP code of residence were not significantly associated with imaging modality selection. HCC was observed in 62 patients (prevalence 4.3%). Rate of HCC detection was significantly higher with MRI vs US (5.9% vs. 1.5%, p = 0.001).MRI was the most frequently used modality (> 50%) for HCC screening in our tertiary care center, in contrast with the current practice guidelines. Race/ethnicity, cirrhosis and referral by a hepatologist were associated with the imaging method used for HCC screening.