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. 2025 Jul 9.
doi: 10.1007/s00261-025-05105-5. Online ahead of print.

Reproducibility and accuracy of non-contrast abbreviated magnetic resonance imaging of the liver in surveillance for early recurrence for hepatocellular carcinoma in a Western population: a multi-reader study

Jordi Rimola  1   2 , Belén Saborido  3 , Alba Igual  4 , Andreu Roca  5 , Anna Darnell  4 , Sergio Jiménez  6 , Alicia Mesa  7 , Vicente Navarro  8 , Alexandre Soler  4 , Carmen Ayuso  4   9 , María Reig  10   11
Affiliations

Reproducibility and accuracy of non-contrast abbreviated magnetic resonance imaging of the liver in surveillance for early recurrence for hepatocellular carcinoma in a Western population: a multi-reader study

Jordi Rimola et al. Abdom Radiol (NY). .

Abstract

Purpose: Abbreviated MRI (AMRI) protocols may represent an alternative to conventional MRI (CMRI) for surveillance of hepatocellular carcinoma (HCC). We aimed to compare the inter-reader agreement and sensitivity of AMRI versus CMRI for HCC recurrence < 2 years after curative ablation in at risk-population.

Methods: Eight radiologists (4 with < 5 years' and 4 with ≥ 5 years' experience) from three institutions reviewed a retrospective serie of 143 CMRI and AMRI from 75 cirrhotic patients (84% HCV and/or alcohol-related) undergoing secondary screening after HCC ablation in a blinded and independent manner, with imaging assessments separated by 1-3 month. We calculated the intra and inter-reader agreement by means Gwet's AC1 for detection of local recurrence at the ablation site, new intrahepatic, and any type of recurrence (either local and/or new intrahepatic) with CMRI and AMRI. Reference diagnoses of recurrent HCC were based on histological or imaging-based criteria.

Results: Early HCC recurrence was detected in 37 (49.3%), including 12 local recurrence, 21 new intrahepatic lesions, 4 had both local recurrence and new intrahepatic lesions. Inter-reader agreement was similarly high for AMRI and CMRI for local recurrence [0.87 (0.83‒0.90) vs. 0.87 (0.83‒0.92)], but higher for AMRI than for CMRI for new intrahepatic [0.85 (0.81‒0.9) vs. 0.6 (0.52‒0.67)] and any type [0.73 (0.67‒0.78) vs. 0.56 (0.49‒0.64)] recurrences. Sensitivity for detecting any type of HCC recurrence was higher for CMRI [0.83 (0.78‒0.87) vs. 0.39 (0.33‒0.45) for AMRI, p < 0.0001].

Conclusions: Compared to CMRI, non-contrast AMRI showed higher inter-observed agreement but with very low sensitivity for early detection of HCC recurrence in a cohort with predominantly HCV and/or alcohol related cirrhosis, making it not suitable for this purpose.

Keywords: Abbreviated magnetic resonance; Hepatocellular carcinoma; Magnetic resonance imaging; Recurrence; Secondary screening; Surveillance.

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Conflict of interest statement

Declarations. Conflict of interest: Jordi Rimola has served as advisor to Roche, MEDIVIR and Universal Dx, and has received lecture or consultancy fees from Astrazeneca and Roche. Alicia Mesa has received lecture feed from GE Healthcare.María Reig has served as advisor and received lectures fee to AstraZeneca, Bayer, BMS, Eli Lilly, Geneos, Ipsen, Merck, Roche, Universal DX, Engitix Therapeutics, MEDIVIR, Biotoscana Farma S.A. Travel suppor by: Astrazeneca, Roche, Bayer, BMS, Lilly, Ipsen. Grant Research Support (to the institution): Bayer, Ipsen. Educational Support (to the institution): Bayer, Astrazeneca, BMS, Eisai- Merck MSD, Roche, Ipsen, Lilly, Terumo, Next, Boston Scientific, Ciscar Medical, Eventy 03 LLC (Egypt).The rest of the authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article.

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