Comparison of ultrasound-detected and undetected hepatocellular carcinomas: a post-hoc, subgroup analysis from the MAGNUS-HCC surveillance trial.

IF 2.5 3区医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Ultrasonography Pub Date : 2025-09-08 DOI:10.14366/usg.25143

Seo Yeon Youn, Moon Hyung Choi, Jeong Hee Yoon, Chang Hee Lee, Tae Wook Kang, Hyun A Kim, Young-Mi Ku, Jeong Min Lee, Seong Hyun Kim, Kyung Ah Kim, Su Lim Lee, Joon-Il Choi

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引用次数: 0

Abstract

Purpose: This study aimed to compare the clinical and imaging features of hepatocellular carcinomas (HCCs) detected versus undetected on surveillance ultrasound (US), based on a prospective cohort.

Methods: This post-hoc subgroup study analyzed data from MAGNUS-HCC trial, a prospective multicenter study evaluating both biannual US and annual non-contrast abbreviated magnetic resonance imaging (NC-AMRI) for HCC surveillance in high-risk patients. Among 34 HCCs, 16 tumors were detected and 18 tumors were undetected on US. We compared clinical features such as sex, age, body mass index (BMI), liver disease etiology, α-fetoprotein (AFP) level, and Child-Pugh class between participants who were diagnosed on US and those who were not. Imaging features including size, hemiliver distribution, anatomical section, subcapsular location, blind spot location, the presence of hepatic steatosis, and the presence of poor sonic window were also compared. NC-AMRI features were also assessed.

Results: No significant differences were observed between US-detected and US-undetected groups in terms of sex, age, liver disease etiology, AFP level, or Child-Pugh class. Patients with US-undetected HCCs had higher BMI (25.7 vs. 23.8 kg/m2, P=0.049). Lesions in blind spots were significantly more common in the US-undetected group (55.6% vs. 18.8%, P=0.039), as were lesions in the left hemiliver (38.9% vs. 6.3%, P=0.043). No significant differences were found in tumor size, anatomical section, subcapsular location, presence of poor sonic window, presence of hepatic steatosis, or magnetic resonance imaging characteristics. Of the 16 US-detected tumors, 62.5% were hypoechoic and 37.5% were hyperechoic.

Conclusion: US is less effective in detecting HCCs in patients with a higher BMI and tumors located in the blind spots or left hemiliver. These limitations should be considered in planning and interpreting surveillance strategies.

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超声检测和未检测肝细胞癌的比较：MAGNUS-HCC监测试验的事后亚组分析。

目的：本研究旨在比较监测超声（US）检测到的和未检测到的肝细胞癌（HCCs）的临床和影像学特征，基于前瞻性队列。方法：这项事后亚组研究分析了来自MAGNUS-HCC试验的数据，这是一项前瞻性多中心研究，评估了每年两次的美国和每年一次的非对比缩短磁共振成像（NC-AMRI）对高危患者HCC监测的影响。在34例hcc中，在US上检测到16例肿瘤，未检测到18例肿瘤。我们比较了临床特征，如性别、年龄、体重指数（BMI）、肝脏疾病病因、α-胎蛋白（AFP）水平和Child-Pugh分级。影像学特征包括肝大小、半肝分布、解剖切片、包膜下位置、盲点位置、有无肝脂肪变性、有无超声窗差。同时评估NC-AMRI特征。结果：us检测组与us未检测组在性别、年龄、肝病病因、AFP水平、Child-Pugh分级等方面均无显著差异。未被us检测到的hcc患者BMI较高（25.7 vs 23.8 kg/m2， P=0.049）。盲点病变在us未检测组中更为常见（55.6%比18.8%，P=0.039），左半肝病变也更为常见（38.9%比6.3%，P=0.043）。在肿瘤大小、解剖剖面、包膜下位置、有无不良声窗、有无肝脂肪变性或磁共振成像特征方面均无显著差异。在16例超声检测肿瘤中，62.5%为低回声，37.5%为高回声。结论：对于BMI较高且肿瘤位于盲点或左半肝的患者，US检测hcc的效果较差。在规划和解释监测战略时应考虑到这些限制。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Ultrasonography Medicine-Radiology, Nuclear Medicine and Imaging

CiteScore

5.10

自引率

6.50%

发文量

审稿时长

15 weeks

期刊介绍： Ultrasonography, the official English-language journal of the Korean Society of Ultrasound in Medicine (KSUM), is an international peer-reviewed academic journal dedicated to practice, research, technology, and education dealing with medical ultrasound. It is renamed from the Journal of Korean Society of Ultrasound in Medicine in January 2014, and published four times per year: January 1, April 1, July 1, and October 1. Original articles, technical notes, topical reviews, perspectives, pictorial essays, and timely editorial materials are published in Ultrasonography covering state-of-the-art content. Ultrasonography aims to provide updated information on new diagnostic concepts and technical developments, including experimental animal studies using new equipment in addition to well-designed reviews of contemporary issues in patient care. Along with running KSUM Open, the annual international congress of KSUM, Ultrasonography also serves as a medium for cooperation among physicians and specialists from around the world who are focusing on various ultrasound technology and disease problems and relevant basic science.