Comparative Analysis of Imaging Modalities for Surveillance on Outcomes in Patients With Hepatocellular Carcinoma

Background and Aims: The American Association for the Study of Liver Diseases recommends regular surveillance with ultrasonography (US) and alpha-feto protein every 6 months for patients at high risk of hepatocellular carcinoma (HCC). However, US is considered to be less effective than cross-section...

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Main Authors: Ahmed El Sabagh, Islam Mohamed, Mazen ElSheikh, Megha Bhongade, Eunji Jo, Susan G. Hilsenbeck, Fasiha Kanwal, Prasun K. Jalal
Format: Article
Language:English
Published: Elsevier 2025-01-01
Series:Gastro Hep Advances
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Online Access:http://www.sciencedirect.com/science/article/pii/S2772572325000913
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author Ahmed El Sabagh
Islam Mohamed
Mazen ElSheikh
Megha Bhongade
Eunji Jo
Susan G. Hilsenbeck
Fasiha Kanwal
Prasun K. Jalal
author_facet Ahmed El Sabagh
Islam Mohamed
Mazen ElSheikh
Megha Bhongade
Eunji Jo
Susan G. Hilsenbeck
Fasiha Kanwal
Prasun K. Jalal
author_sort Ahmed El Sabagh
collection DOAJ
description Background and Aims: The American Association for the Study of Liver Diseases recommends regular surveillance with ultrasonography (US) and alpha-feto protein every 6 months for patients at high risk of hepatocellular carcinoma (HCC). However, US is considered to be less effective than cross-sectional imaging modalities like computed tomography and magnetic resonance imaging for detecting early HCC. Limited data exist on the overall survival and receipt of curative treatment for patients undergoing surveillance with different imaging modalities. Methods: We retrospectively reviewed patients (n = 1954) diagnosed with HCC between January 2011 and June 2021. Patients who developed HCC while on strict semiannual surveillance were included in the study. We estimated survival using the Kaplan-Meier method and compared the outcomes on different modalities of imaging using the Log Rank test. We used univariate and multivariate Cox model to evaluate factors affecting survival. Results: A total of 183 patients developed HCC on semiannual surveillance with Imaging (115 with contrast-enhanced magnetic resonance imaging, 34 with multiphasic computed tomography and 34 with US) and alpha-feto protein. No significant difference was noted in overall survival or transplant-free survival based on the imaging modality employed for surveillance for at-risk patients. No correlation was found between the type of imaging modality for surveillance and receipt of curative treatment. Conclusion: Using surveillance program rigorously in at-risk patients, we did not find any association between the imaging modality and clinical outcomes in patients with HCC. It is likely that adherence to surveillance program irrespective of imaging modalities is more effective to influence the outcome, but it needs further studies.
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spelling doaj-art-e331c8ff660846bb8369cad9e4a9cc202025-08-20T02:48:07ZengElsevierGastro Hep Advances2772-57232025-01-014910070410.1016/j.gastha.2025.100704Comparative Analysis of Imaging Modalities for Surveillance on Outcomes in Patients With Hepatocellular CarcinomaAhmed El Sabagh0Islam Mohamed1Mazen ElSheikh2Megha Bhongade3Eunji Jo4Susan G. Hilsenbeck5Fasiha Kanwal6Prasun K. Jalal7Section of Gastroenterology and Hepatology, Baylor College of Medicine, Houston, Texas, United States; Correspondence: Address correspondence to: Ahmed El Sabagh, MBChB, MSc, Section of Gastroenterology and Hepatology, Baylor College of Medicine, 1 Baylor Plaza, Houston, Texas 77030.Section of Gastroenterology and Hepatology, Baylor College of Medicine, Houston, Texas, United StatesSection of Gastroenterology and Hepatology, Baylor College of Medicine, Houston, Texas, United StatesSection of Gastroenterology and Hepatology, Baylor College of Medicine, Houston, Texas, United StatesSection of Gastroenterology and Hepatology, Baylor College of Medicine, Houston, Texas, United States; Dan L Duncan Comprehensive Cancer Center, Baylor College of Medicine, Houston, Texas, United StatesSection of Gastroenterology and Hepatology, Baylor College of Medicine, Houston, Texas, United States; Dan L Duncan Comprehensive Cancer Center, Baylor College of Medicine, Houston, Texas, United StatesSection of Gastroenterology and Hepatology, Baylor College of Medicine, Houston, Texas, United StatesSection of Gastroenterology and Hepatology, Baylor College of Medicine, Houston, Texas, United StatesBackground and Aims: The American Association for the Study of Liver Diseases recommends regular surveillance with ultrasonography (US) and alpha-feto protein every 6 months for patients at high risk of hepatocellular carcinoma (HCC). However, US is considered to be less effective than cross-sectional imaging modalities like computed tomography and magnetic resonance imaging for detecting early HCC. Limited data exist on the overall survival and receipt of curative treatment for patients undergoing surveillance with different imaging modalities. Methods: We retrospectively reviewed patients (n = 1954) diagnosed with HCC between January 2011 and June 2021. Patients who developed HCC while on strict semiannual surveillance were included in the study. We estimated survival using the Kaplan-Meier method and compared the outcomes on different modalities of imaging using the Log Rank test. We used univariate and multivariate Cox model to evaluate factors affecting survival. Results: A total of 183 patients developed HCC on semiannual surveillance with Imaging (115 with contrast-enhanced magnetic resonance imaging, 34 with multiphasic computed tomography and 34 with US) and alpha-feto protein. No significant difference was noted in overall survival or transplant-free survival based on the imaging modality employed for surveillance for at-risk patients. No correlation was found between the type of imaging modality for surveillance and receipt of curative treatment. Conclusion: Using surveillance program rigorously in at-risk patients, we did not find any association between the imaging modality and clinical outcomes in patients with HCC. It is likely that adherence to surveillance program irrespective of imaging modalities is more effective to influence the outcome, but it needs further studies.http://www.sciencedirect.com/science/article/pii/S2772572325000913HCCLiver transplantationMRIracial disparitiesSurveillancesurvival
spellingShingle Ahmed El Sabagh
Islam Mohamed
Mazen ElSheikh
Megha Bhongade
Eunji Jo
Susan G. Hilsenbeck
Fasiha Kanwal
Prasun K. Jalal
Comparative Analysis of Imaging Modalities for Surveillance on Outcomes in Patients With Hepatocellular Carcinoma
Gastro Hep Advances
HCC
Liver transplantation
MRI
racial disparities
Surveillance
survival
title Comparative Analysis of Imaging Modalities for Surveillance on Outcomes in Patients With Hepatocellular Carcinoma
title_full Comparative Analysis of Imaging Modalities for Surveillance on Outcomes in Patients With Hepatocellular Carcinoma
title_fullStr Comparative Analysis of Imaging Modalities for Surveillance on Outcomes in Patients With Hepatocellular Carcinoma
title_full_unstemmed Comparative Analysis of Imaging Modalities for Surveillance on Outcomes in Patients With Hepatocellular Carcinoma
title_short Comparative Analysis of Imaging Modalities for Surveillance on Outcomes in Patients With Hepatocellular Carcinoma
title_sort comparative analysis of imaging modalities for surveillance on outcomes in patients with hepatocellular carcinoma
topic HCC
Liver transplantation
MRI
racial disparities
Surveillance
survival
url http://www.sciencedirect.com/science/article/pii/S2772572325000913
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