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Purpose <p>Abbreviated MRI (AMRI) protocols may represent an alternative to conventional MRI (CMRI) for surveillance of hepatocellular carcinoma (HCC). We aimed to compare the inter-reader agreement and sensitivity of AMRI versus CMRI for HCC recurrence &lt; 2 years after curative ablation in at risk-population.</p> Methods <p>Eight radiologists (4 with &lt; 5 years’ and 4 with ≥ 5 years’ experience) from three institutions reviewed a retrospective serie of 143 CMRI and AMRI from 75 cirrhotic patients (84% HCV and/or alcohol-related) undergoing secondary screening after HCC ablation in a blinded and independent manner, with imaging assessments separated by 1–3 month. We calculated the intra and inter-reader agreement by means Gwet’s AC1 for detection of local recurrence at the ablation site, new intrahepatic, and any type of recurrence (either local and/or new intrahepatic) with CMRI and AMRI. Reference diagnoses of recurrent HCC were based on histological or imaging-based criteria.</p> Results <p>Early HCC recurrence was detected in 37 (49.3%), including 12 local recurrence, 21 new intrahepatic lesions, 4 had both local recurrence and new intrahepatic lesions. Inter-reader agreement was similarly high for AMRI and CMRI for local recurrence [0.87 (0.83‒0.90) vs. 0.87 (0.83‒0.92)], but higher for AMRI than for CMRI for new intrahepatic [0.85 (0.81‒0.9) vs. 0.6 (0.52‒0.67)] and any type [0.73 (0.67‒0.78) vs. 0.56 (0.49‒0.64)] recurrences. Sensitivity for detecting any type of HCC recurrence was higher for CMRI [0.83 (0.78‒0.87) vs. 0.39 (0.33‒0.45) for AMRI, <i>p</i> &lt; 0.0001].</p> Conclusions <p>Compared to CMRI, non-contrast AMRI showed higher inter-observed agreement but with very low sensitivity for early detection of HCC recurrence in a cohort with predominantly HCV and/or alcohol related cirrhosis, making it not suitable for this purpose.</p>

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Reproducibility and accuracy of non-contrast abbreviated magnetic resonance imaging of the liver in surveillance for early recurrence for hepatocellular carcinoma in a Western population: a multi-reader study

  • 期刊论文

  • 发表日期：

    2025年7月9日

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  • Jordi Rimola,
  • Belén Saborido,
  • Alba Igual,
  • Andreu Roca,
  • Anna Darnell,
  • Sergio Jiménez,
  • Alicia Mesa,
  • Vicente Navarro,
  • Alexandre Soler,
  • Carmen Ayuso,
  • María Reig

摘要

Purpose

Abbreviated MRI (AMRI) protocols may represent an alternative to conventional MRI (CMRI) for surveillance of hepatocellular carcinoma (HCC). We aimed to compare the inter-reader agreement and sensitivity of AMRI versus CMRI for HCC recurrence < 2 years after curative ablation in at risk-population.

Methods

Eight radiologists (4 with < 5 years’ and 4 with ≥ 5 years’ experience) from three institutions reviewed a retrospective serie of 143 CMRI and AMRI from 75 cirrhotic patients (84% HCV and/or alcohol-related) undergoing secondary screening after HCC ablation in a blinded and independent manner, with imaging assessments separated by 1–3 month. We calculated the intra and inter-reader agreement by means Gwet’s AC1 for detection of local recurrence at the ablation site, new intrahepatic, and any type of recurrence (either local and/or new intrahepatic) with CMRI and AMRI. Reference diagnoses of recurrent HCC were based on histological or imaging-based criteria.

Results

Early HCC recurrence was detected in 37 (49.3%), including 12 local recurrence, 21 new intrahepatic lesions, 4 had both local recurrence and new intrahepatic lesions. Inter-reader agreement was similarly high for AMRI and CMRI for local recurrence [0.87 (0.83‒0.90) vs. 0.87 (0.83‒0.92)], but higher for AMRI than for CMRI for new intrahepatic [0.85 (0.81‒0.9) vs. 0.6 (0.52‒0.67)] and any type [0.73 (0.67‒0.78) vs. 0.56 (0.49‒0.64)] recurrences. Sensitivity for detecting any type of HCC recurrence was higher for CMRI [0.83 (0.78‒0.87) vs. 0.39 (0.33‒0.45) for AMRI, p < 0.0001].

Conclusions

Compared to CMRI, non-contrast AMRI showed higher inter-observed agreement but with very low sensitivity for early detection of HCC recurrence in a cohort with predominantly HCV and/or alcohol related cirrhosis, making it not suitable for this purpose.