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Brunsing et al. Hepatoma Res 2020;6:59 Hepatoma Research
DOI: 10.20517/2394-5079.2020.50

Review Open Access

Alternative approach of hepatocellular carcinoma
surveillance: abbreviated MRI

Ryan L. Brunsing , Kathryn J. Fowler , Takeshi Yokoo , Guilherme Moura Cunha , Claude B. Sirlin ,
3
2
2
2
1
Robert M. Marks 4,5
1 Department of Radiology, Stanford University, Stanford, CA 94305, USA.
2 Liver Imaging Group, Department of Radiology, University of California San Diego, San Diego, CA 92093, USA.
3 Department of Radiology, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA.
4 Department of Radiology, Naval Medical Center San Diego, San Diego, CA 92134, USA.
5 Department of Radiology, Uniformed Services University of the Health Sciences, Bethesda, MD 20892, USA.
Correspondence to: Dr. Robert M. Marks, Department of Radiology, Naval Medical Center San Diego, San Diego, CA 92134,
USA. E-mail: robert.m.marks.mil@mail.mil
How to cite this article: Brunsing RL, Fowler KJ, Yokoo T, Cunha GM, Sirlin CB, Marks RM. Alternative approach of hepatocellular
carcinoma HCC surveillance: abbreviated MRI. Hepatoma Res 2020;6:59. http://dx.doi.org/10.20517/2394-5079.2020.50
Received: 11 May 2020 First Decision: 17 Jun 2020 Revised: 6 Jul 2020 Accepted: 8 Jul 2020 Published: 1 Sep 2020

Academic Editor: Yuko Kono Copy Editor: Cai-Hong Wang Production Editor: Jing Yu
Received: First Decision: Revised: Accepted: Published:

Science Editor: Copy Editor: Production Editor: Jing Yu Abstract
This review focuses on emerging abbreviated magnetic resonance imaging (AMRI) surveillance of patients with
chronic liver disease for hepatocellular carcinoma (HCC). This surveillance strategy has been proposed as a high-
sensitivity alternative to ultrasound for identification of patients with early-stage HCC, particularly in patients with
cirrhosis or obesity, in whom sonographic visualization of small tumors may be compromised. Three general AMRI
approaches have been developed and studied in the literature - non-contrast AMRI, dynamic contrast-enhanced
AMRI, and hepatobiliary phase contrast-enhanced AMRI - each comprising a small number of selected sequences
specifically tailored for HCC detection. The rationale, general technique, advantages and disadvantages, and
diagnostic performance of each AMRI approach is explained. Additionally, current gaps in knowledge and future
directions are discussed. Based on emerging evidence, we cautiously recommend the use of AMRI for HCC
surveillance in situations where ultrasound is compromised.

Keywords: Abbreviated magnetic resonance imaging, cirrhosis, Hepatitis B, hepatocellular carcinoma, surveillance,
magnetic resonance imaging

© The Author(s) 2020. Open Access This article is licensed under a Creative Commons Attribution 4.0
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