Abbreviated Magnetic Resonance Imaging and Biomarker-Based Detection of Early Liver Cancer
Abstract
Hepatocellular carcinoma (HCC) is the second leading cause of cancer-related death worldwide and is the fastest growing cause of cancer death in the United States. Current national guidelines recommend surveillance of all patients at risk for HCC with a lab draw and an Ultrasound (US) examination every 6 months. However, many studies have shown that Ultrasounds ability to detect cancer reliably, especially small tumors, is poor. Many centers in the United States perform contrast-enhanced magnetic resonance imaging (MRI) for HCC surveillance as it has been shown to be more accurate in the detection of HCC than US. However, complete contrast-enhanced MRI is too expensive to be considered a first line surveillance examination. We previously simulated and studied a novel abbreviated MRI (AMRI) protocol, using a unique intravenous contrast agent used for liver MRIs that takes approximately 10 minutes to complete. We found that the accuracy of the AMRI protocol was 20% better than that of US. We have shown that in moderate to high-risk groups, AMRI is more cost effective than US. We now seek to fill remaining gaps by rigorously comparing the performance of AMRI vs. US for HCC screening in a large prospectively assembled cohort of subjects at risk for HCC; assessing the added diagnostic value of clinical biomarkers (AFP, AFP-L3, DCP) and other clinical variables; examine the cost effectiveness of AMRI, US, and of each imaging method in combination with clinical biomarkers; and bank biospecimens for future biomarker discovery studies.
Document Details
- Document Type
- Technical Report
- Publication Date
- Oct 01, 2020
- Accession Number
- AD1117635
Entities
People
- Robert J. Marks
Organizations
- Henry M. Jackson Foundation for the Advancement of Military Medicine