Surveillance failure in ultrasound for hepatocellular carcinoma: a systematic review and meta-analysis
Dong Hwan Kim, Seung Baek Hong, Sang Hyun Choi, So Yeon Kim, Ju Hyun Shim, Ji Sung Lee, Joon‐Il Choi, Suk Kim
Abstract
Recently, various advances have been achieved in the diagnosis and treatment of hepatocellular carcinoma (HCC).1 We read with great interest the paper by De Toni et al 2 demonstrating the importance of early diagnosis of HCC by surveillance with respect to survival benefits, and that by Zeng et al 3 emphasising risk stratifications in HCC surveillance. As these papers suggest, effective surveillance to detect early stage HCC is crucial in the management of patients at-risk. Although ultrasound (US) is recommended as a standard surveillance modality,4 5 the sensitivity of US for detecting early stage HCC is suboptimal, being only 47%.6 Updated guidelines suggest alternative surveillance tools including MRI in patients likely to have inadequate US examinations.4 5 Recently, MRI surveillance, including abbreviated MRI-protocols, has been drawing attention because of its high diagnostic performance compared with US.7 8 However, considering its cost and availability, MRI surveillance cannot be applied to all at-risk patients, but should be done in patients who are prone to US surveillance failures and benefit from MRI surveillance. Thus, we conducted a meta-analysis to evaluate the incidence …