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한빛사논문
- 조회148
Gastroenterology, January 22, 2025 | https://doi.org/10.1053/j.gastro.2024.12.035
Non-contrast magnetic resonance imaging versus ultrasonography for hepatocellular carcinoma surveillance: A randomized, single-center trial
Hyungjin Rhee1, Myeong-Jin Kim1§, Do Young Kim2§, Chansik An1, Wonseok Kang2, Kyunghwa Han1, Yun Ho Roh3, Kwang-Hyub Han2, Sang Hoon Ahn2, Jin-Young Choi1, Jun Yong Park2, Yong Eun Chung1, Seung Up Kim2, Beom Kyung Kim2, Sunyoung Lee1, Hye Won Lee2, Jae Seung Lee2
1Department of Radiology, Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
2Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
3Biostatistics Collaboration Unit, Medical Research Center, Yonsei University College of Medicine, Seoul, South Korea
Chansik An is currently affiliated with Department of Radiology, CHA Bundang Medical Center, CHA University, Gyeonggi-do, South Korea.
Wonseok Kang is currently affiliated with Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
Kwang-Hyub Han is currently affiliated with Department of Medicine, CHA Gangnam Medical Center, CHA University, Seoul, South Korea.
§Co-corresponding authors
Corresponding authors: Myeong-Jin Kim, M.D., Ph.D., Do Young Kim, M.D., PhD.
1Department of Radiology, Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
2Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
3Biostatistics Collaboration Unit, Medical Research Center, Yonsei University College of Medicine, Seoul, South Korea
Chansik An is currently affiliated with Department of Radiology, CHA Bundang Medical Center, CHA University, Gyeonggi-do, South Korea.
Wonseok Kang is currently affiliated with Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
Kwang-Hyub Han is currently affiliated with Department of Medicine, CHA Gangnam Medical Center, CHA University, Seoul, South Korea.
§Co-corresponding authors
Corresponding authors: Myeong-Jin Kim, M.D., Ph.D., Do Young Kim, M.D., PhD.
Abstract
Background & Aims
This study aimed to compare ultrasonography (US) and non-contrast magnetic resonance imaging (MRI) in the surveillance of hepatic malignancy.
Methods
We conducted a randomized, non-blinded, single-center trial at a single center in South Korea. Eligible individuals were aged 20–70 years with liver cirrhosis, Child–Pugh class A, and no history of liver cancer or other recent malignancy. Participants were randomized 1:1 to receive up to ten semiannual surveillance using US or non-contrast MRI with serum alpha-fetoprotein testing. The primary endpoints were the detection rates of Barcelona Clinic Liver Cancer [BCLC] stage 0 or A tumors, stage distribution at initial diagnosis, and false-positive referral rates.
Results
From June 2015 to November 2017, 416 patients were screened, and 414 were enrolled and assigned to the US (n=207) or MRI (n=207) group. In total, 23 participants in US group and 25 in MRI group were diagnosed with liver cancer by November 2022. The detection rates of BCLC stage 0 or A tumors were not different between the US and MRI groups (8% [95% confidence interval (CI), 5 – 13%] versus 12% [8 – 17%]). BCLC stage 0 tumors were more prevalent in the MRI group than in the US group (8% versus 3%). The MRI group had earlier BCLC stage (P=0.014) and lower false-positive referral rate (0.7% [95% CI, 0.4 – 1.2%] versus 3.1% [2.3 – 4.1%], P <0.001) compared to the US group.
Conclusions
Non-contrast MRI is a better alternative to US for the surveillance of cirrhotic patients offering earlier stage at initial diagnosis and lower false-positive referral rate. ClincalTrials.gov, NCT02514434.
This study aimed to compare ultrasonography (US) and non-contrast magnetic resonance imaging (MRI) in the surveillance of hepatic malignancy.
Methods
We conducted a randomized, non-blinded, single-center trial at a single center in South Korea. Eligible individuals were aged 20–70 years with liver cirrhosis, Child–Pugh class A, and no history of liver cancer or other recent malignancy. Participants were randomized 1:1 to receive up to ten semiannual surveillance using US or non-contrast MRI with serum alpha-fetoprotein testing. The primary endpoints were the detection rates of Barcelona Clinic Liver Cancer [BCLC] stage 0 or A tumors, stage distribution at initial diagnosis, and false-positive referral rates.
Results
From June 2015 to November 2017, 416 patients were screened, and 414 were enrolled and assigned to the US (n=207) or MRI (n=207) group. In total, 23 participants in US group and 25 in MRI group were diagnosed with liver cancer by November 2022. The detection rates of BCLC stage 0 or A tumors were not different between the US and MRI groups (8% [95% confidence interval (CI), 5 – 13%] versus 12% [8 – 17%]). BCLC stage 0 tumors were more prevalent in the MRI group than in the US group (8% versus 3%). The MRI group had earlier BCLC stage (P=0.014) and lower false-positive referral rate (0.7% [95% CI, 0.4 – 1.2%] versus 3.1% [2.3 – 4.1%], P <0.001) compared to the US group.
Conclusions
Non-contrast MRI is a better alternative to US for the surveillance of cirrhotic patients offering earlier stage at initial diagnosis and lower false-positive referral rate. ClincalTrials.gov, NCT02514434.
논문정보
- Research article
- 2025년 01월 (BRIC 등록일 2025-01-23)
- 국내 연구진
- 의약학 > 종양의학
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