Non-contrast MRI, early diagnosis rate of liver cancer by 96%...22% higher than ultrasound
Feb 26, 2025
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The findings were published in the official journal of the American Society of Gastroenterology (IF 26.3).
Patients with chronic hepatitis and cirrhosis have a high risk of developing liver cancer, so ultrasound surveillance tests are generally performed every six months to check for liver cancer. However, ultrasound has limitations in detecting small lesions of the liver, so even if they undergo regular ultrasound, 25-30% of patients find liver cancer in a stage where radical treatment is difficult.
CT and MRI using contrast medium are one of the ways to improve the sensitivity of ultrasound. However, it is not easy to use due to high cost, long test time, and contrast medium complications.
To solve this problem, the research team introduced MRI without contrast medium as a surveillance test method and compared its effectiveness with conventional ultrasound tests. The non-contrast MRI used in this study is a simplified MRI test that only captures images essential for the detection of liver cancer, which has the advantage of short test time and low cost burden, as well as less concern about related side effects due to the use of contrast agents and radiation.
The research team recruited 414 patients with cirrhosis for 30 months from 2015. Up to 10 monitoring tests were performed every six months using ultrasound and non-contrast MRI, respectively, for each half of the patients. During the study period, 23 patients in the ultrasound examination group and 25 patients in the non-contrast MRI examination group were diagnosed with liver cancer. Patients who underwent noncontrast MRI scans were able to detect liver cancer at lower stage.
Patient staging was classified into 0 (every early stage), A (early stage), B (intermediate stage), and C (advanced stage) according to the Barcelona Clinic Liver Clinic (BCLC) grade. Usually, up to A, radical treatments such as liver replacement, high-frequency heat therapy, and liver transplantation are possible, but from B, radical treatments are difficult, which is considered a failure of surveillance tests.
In the non-contrast MRI test group, 96% were diagnosed with liver cancer early (0~A), but in the ultrasound test group, only 74%. In particular, the proportion of patients found in stage 0 was 64% higher in the non-contrast MRI test group than in the ultrasound test group (26%). In addition, 17% of patients diagnosed with stage C were in the ultrasound examination group, while none were in the non-contrast MRI examination group.
83% of liver cancer patients in the non-contrast MRI examination group received radical treatment, but only 38% of liver cancer patients in the ultrasound examination group remained. In addition, the incidence of false positives (if not positive but incorrectly diagnosed) was also lower in the non-contrast MRI test group (0.7%) than in the ultrasound test group (3.1%).
Professor Kim Myung-jin explained that "ultrasonic surveillance tests have contributed greatly to early detection of liver cancer and improvement of survival rates, but due to the nature of the test, early diagnosis often failed."Non-contrast MRI surveillance tests not only have high convenience due to short test time and no contrast medium, but also have a great advantage in that liver cancer can be detected early with high probability."
Professor Kim Do-young then said "In the course of the research, I was able to feel the accuracy of the non-contrast MRI."Patients with diagnosed liver cancer were able to receive radical treatment with a high probability, and the incidence of false positives was also low, reducing the cost and psychological burden of additional tests."," he added.
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This article was translated by Naver AI translator.
