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IF 4.7 2区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

European Radiology Pub Date : 2025-03-20 DOI:10.1007/s00330-025-11517-0

Hyun Kyung Yang, Sunyoung Lee, Min Young Lee, Myeong-Jin Kim

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引用次数: 0

摘要

目的：非对比度简略磁共振成像（NC-AMRI）正在成为超声波（US）的一种有前途的替代方法，用于监测高危患者的肝细胞癌（HCC）。我们的目的是评估 NC-AMRI 在实际监测人群中的有效性，并评估 NC-AMRI 是否适用于既往超声检查不足的特定患者：这项回顾性研究纳入了 2018 年 12 月至 2022 年 8 月期间接受 NC-AMRI 的任何原因引起的慢性乙型肝炎或肝硬化的 Child-Pugh A 级或 B 级成人患者。对早期和极早期检测、接受治愈性治疗和错误转诊进行了评估。对之前未接受充分US检查的患者进行了分组分析。结果在 1853 名患者（平均年龄 58.8 岁，男性 1045 人）中，有 61 人（61/1853，3.3%，95% 置信区间：2.5-4.2）患上 68 例 HCC。早期和极早期发现的比例分别为 95.1%（58/61，72.2-100.0）和 70.5%（43/61，51.0-95.0）；接受治愈性治疗的比例为 67.2%（41/61，48.2-91.2）；错误转诊的比例为 12.9%（9/70，5.9-24.4）。在 375 名既往 US 检查结果不足的患者中，早期和极早期检测比例分别为 94.7%（18/19，56.2-100.0）和 57.9%（11/19，28.9-100.0）；接受治疗比例为 52.6%（10/19，25.2-96.8）；误诊比例为 17.4%（4/23，4.7-44.5）：NC-AMRI可能是一种有效的HCC监测模式，因为它在早期和极早期检测、接受根治性治疗和错误转诊方面都取得了成果。NC-AMRI可作为一种替代的HCC监测策略，特别是对于之前未进行充分US检查的患者：问题没有足够的证据支持将非对比度简略磁共振成像作为一种有效的监测工具用于大量实际监测人群。研究结果使用非对比度简略磁共振成像，大多数在监测期间出现 HCC 的患者都能在早期阶段得到诊断，误诊率为 12.9%，可以接受。临床意义非对比度简略磁共振成像是一种有效的 HCC 监测模式，尤其适用于之前未进行充分超声检查的患者。

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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Effectiveness of noncontrast-abbreviated magnetic resonance imaging in a real-world hepatocellular carcinoma surveillance.

Objectives: Noncontrast-abbreviated magnetic resonance imaging (NC-AMRI) is emerging as a promising alternative to ultrasound (US) for surveillance of hepatocellular carcinoma (HCC) in at-risk patients. We aimed to assess the effectiveness of NC-AMRI in a real-world surveillance population, and to evaluate the appropriateness of NC-AMRI in selected patients with inadequate prior US.

Materials and methods: This retrospective study included Child-Pugh class A or B adults with chronic hepatitis B or cirrhosis from any cause who underwent NC-AMRI between December 2018 and August 2022. Early- and very early-stage detection, receipt of curative treatment, and false referral were evaluated. Subgroup analysis was performed for patients with inadequate prior US examinations. Descriptive statistics were used.

Results: Among the 1853 patients (mean age, 58.8 years; 1045 males), 68 HCCs developed in 61 (61/1853, 3.3%, 95% confidence interval: 2.5-4.2) patients. The proportions of early- and very early-stage detection were 95.1% (58/61, 72.2-100.0) and 70.5% (43/61, 51.0-95.0); receipt of curative treatment, 67.2% (41/61, 48.2-91.2); and proportion of false referral, 12.9% (9/70, 5.9-24.4). Among the 375 patients with inadequate prior US, the proportions of early- and very early-stage detection were 94.7% (18/19, 56.2-100.0) and 57.9% (11/19, 28.9-100.0); receipt of curative treatment, 52.6% (10/19, 25.2-96.8); and proportion of false referrals, 17.4% (4/23, 4.7-44.5).

Conclusion: NC-AMRI may be an effective HCC surveillance modality given the results related to early- and very early-stage detection, receipt of curative treatment, and false referral. NC-AMRI can be an alternative HCC surveillance strategy, especially for patients with inadequate prior US examinations.

Key points: Question There is insufficient evidence to support the use of noncontrast-abbreviated MRI as an effective surveillance tool in large real-life populations under surveillance. Findings Using noncontrast-abbreviated MRI, most patients who developed HCCs during surveillance were diagnosed at an early stage, with an acceptable false referral rate of 12.9%. Clinical relevance Noncontrast-abbreviated MRI is an effective HCC surveillance modality, especially for patients with inadequate prior ultrasound examinations.

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来源期刊

European Radiology 医学-核医学

CiteScore

11.60

自引率

8.50%

发文量

874

审稿时长

2-4 weeks

期刊介绍： European Radiology (ER) continuously updates scientific knowledge in radiology by publication of strong original articles and state-of-the-art reviews written by leading radiologists. A well balanced combination of review articles, original papers, short communications from European radiological congresses and information on society matters makes ER an indispensable source for current information in this field. This is the Journal of the European Society of Radiology, and the official journal of a number of societies. From 2004-2008 supplements to European Radiology were published under its companion, European Radiology Supplements, ISSN 1613-3749.