Abbreviated Magnetic Resonance Imaging and Biomarker-Based Detection of Early Liver Cancer
Technical Report,30 Sep 2018,29 Sep 2019
The Henry M. Jackson Foundation for the Advancement of Military Medicine Bethesda United States
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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 percent 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, AFPL3,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.
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