Non-contrast MRI detects liver cancer earlier and more accurately than ultrasound, a new Gastroenterology study published in January by Severance Hospital shows, challenging long-standing surveillance standards for high-risk patients. Current guidelines recommend ultrasound every six months for patients with liver cirrhosis or chronic hepatitis, but the imaging method struggles with small tumor detection. Even with regular screening, up to 30 percent of patients are diagnosed too late for curative treatment. Contrast-enhanced CT and MRI improve sensitivity but are limited by high costs, long scan times, and risks associated with contrast agents.

The study suggests non-contrast MRI could be a more practical alternative, offering shorter scan times, lower costs, and eliminating contrast-related complications. The randomized, single-center trial followed 414 cirrhosis patients in Korea for 30 months. Participants received either ultrasound or non-contrast MRI screening every six months, up to 10 times per patient. By the study’s end, 23 patients in the ultrasound group and 25 in the MRI group were diagnosed with liver cancer. 

According to the study, MRI detected more cases at very early stages (BCLC Stage 0 or A), where curative treatment options like liver resection, ablation, or transplantation remain viable. Ultrasound has long been the standard for liver cancer surveillance, but its limitations leave too many patients undiagnosed at a treatable stage, said Kim of the Department of Radiology. Non-contrast MRI provides a faster, more accurate alternative without the drawbacks of contrast agents.

Source: https://www.koreabiomed.com/news/articleView.html?idxno=26737