Abbreviated MRI for HCC Screening: Extracellular vs. Hepatobiliary Agents
Bachir Taouli1
1Radiology, Icahn School of Medicine at Mount Sinai, New York, United States

Synopsis

Keywords: Body: Liver

In this presentation, we will discuss current guidelines for HCC screening/surveillance, and limitations of US screening, and the opportunities based on abbreviated MRI for this indication. Advantages and limitations of extracellular vs hepatobiliary gadolinium based contrast agents will be discussed.

Practice guidelines recommend the use of ultrasound (US) every 6 months in patients at risk of developing hepatocellular carcinoma (HCC). However, US performs poorly for detection of small lesions. Although MRI is the imaging method of reference for hepatocellular carcinoma (HCC) diagnosis and staging, current practice guidelines do not advocate the use of MRI for HCC screening, due to long exam duration, limited access and cost. In reality, MRI is often used in transplant centers for HCC screening and surveillance. Abbreviated MRI (AMRI) protocols are being evaluated as an alternative to US for HCC screening. AMRI protocols rely on the use of a few selected MRI sequences to address specific questions such as HCC detection. The main goal of AMRI is to keep acceptable diagnostic performance for HCC detection while reducing acquisition time and cost. Several studies have reported various protocols for AMRI, including non-contrast AMRI, hepatobiliary phase AMRI using gadoxetate as well as dynamic AMRI using extracellular contrast agents.
In this lecture, we will discuss the following objectives:
  • Learn about current guidelines for HCC screening/surveillance.
  • Learn about the limitations of ultrasound for HCC screening/surveillance.
  • Discuss the best AMRI approaches for liver cancer screening by using extracellular vs liver specific contrast agents, with pros and cons.
  • Discuss future directions

Acknowledgements

No acknowledgement found.

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Proc. Intl. Soc. Mag. Reson. Med. 31 (2023)