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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 al2 demonstrating the importance of early diagnosis of HCC by surveillance with respect to survival benefits, and that by Zeng et al3 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 …
DHK and SBH are joint first authors.
Contributors DHK and SBH are co-first authors. SHC contributed to the study concept and design. SHC, DHK and SBH acquired, analysed and interpreted the data. DHK and SHC drafted the manuscript. SHC, DHK and JSL performed statistical analysis. JHS, SYK, J-IC and SK made critical revisions to the manuscript. SHC supervised the study.
Funding This work was supported by the National Research Foundation of Korea (NRF) grant funded by the Korea government (MSIT) (grant number: NRF-2019R1G1A1099743).
Competing interests SHC receives research funding from Bayer Healthcare outside the submitted work. J-IlC received research funding from Bayer Healthcare, Guerbet Korea, Bracco Korea, GE Healthcare, and Starmed, and received honorariums from Bayer Healthcare, Samsung Medison, Samsung Electronics, Guerbet Korea, and Bracco Korea outside the submitted work.
Patient consent for publication Not required.
Provenance and peer review Not commissioned; externally peer reviewed.
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