Clinical and Molecular Hepatology

"Won Chang"

Original Article

Non-contrast magnetic resonance imaging for detection of late recurrent hepatocellular carcinoma after curative treatment: a prospective multicenter comparison to contrast-enhanced computed tomography: Dong Wook Kim, Won Chang, So Yeon Kim, Young-Suk Lim, Jonggi Choi, Jungheum Cho, Jin-Wook Kim, Jai Young Cho, Sun Kyung Jeon, Yun Bin Lee, Eun Ju Cho, Su Jong Yu, Kyung-Suk Suh, Kwang-Woong Lee, Dong Ho Lee; Clin Mol Hepatol 2025;31(4):1285-1297.
Published online June 13, 2025; DOI: https://doi.org/10.3350/cmh.2025.0258

Background/Aims
Hepatocellular carcinoma (HCC) frequently recurs after curative treatment, posing challenges to long-term survival. Although contrast-enhanced multiphasic computed tomography (CECT) is commonly used for detecting recurrence, it is associated with risks such as radiation exposure and contrast agent reactions. This study aimed to compare the diagnostic performance of non-contrast magnetic resonance imaging (NC-MRI) with CECT for detecting recurrent HCC.
Methods
In this prospective multicenter intra-individual head-to-head comparison trial (study identifier: NCT05690451, KCT0006395), participants who had undergone curative treatment for HCC and remained recurrence-free for over two years were enrolled. Each participant underwent three follow-up imaging sessions at 2–6-month intervals using both CECT and NC-MRI. The primary outcome was the detection accuracy of each modality, analyzed using the generalized estimating equation analysis. Secondary outcomes included sensitivity and specificity.
Results
The study included 203 participants with a total of 528 paired imaging sessions, identifying recurrent HCC in 22 cases (10.8%). Among these, 21 cases involved intrahepatic recurrence with a median tumor size of 1.3 cm, and one case had aortocaval lymph node metastasis. NC-MRI achieved a detection accuracy of 96.6% (196/203), higher than CECT’s 91.6% (186/203) (P=0.006). NC-MRI also showed greater sensitivity (77.3% [17/22] vs. 36.4% [8/22]; P=0.012), while specificity was comparable between NC-MRI and CECT (98.9% [179/181] vs. 98.3% [178/181]; P=0.999).
Conclusions
NC-MRI demonstrated higher sensitivity and accuracy compared to CECT in detecting recurrent HCC in patients who had been disease-free for over two years following curative treatment, indicating its potential as a preferred imaging modality for this purpose.

Citations

Citations to this article as recorded by

Non-contrast magnetic resonance imaging outperforms contrast-enhanced computed tomography in preoperative detection of hepatocellular carcinoma: A paired validation study
Laizhu Zhang, Weiwei Zong, Jialin Gao, Huan Li, Leizhou Xia, Xiaoli Mai, Jun Chen, Binghua Li, Decai Yu
Clinical and Molecular Hepatology.2026; 32(1): e34. CrossRef
Updates in Abbreviated MRI‐Based HCC Surveillance
Hyo Jung Park, So Yeon Kim, Young‐Suk Lim
Journal of Gastroenterology and Hepatology.2026; 41(3): 914. CrossRef
Moving beyond Ultrasound for Hepatocellular Carcinoma Surveillance in High-Risk Patients with Chronic Hepatitis B
Hae Lim Lee
Gut and Liver.2026; 20(2): 174. CrossRef
Correspondence to editorial on “Non-contrast magnetic resonance imaging for detection of late recurrent hepatocellular carcinoma after curative treatment: a prospective multicenter comparison to contrast-enhanced computed tomography”
Dong Ho Lee
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Correspondence to letter to the editor on “Non-contrast magnetic resonance imaging for detection of late recurrent hepatocellular carcinoma after curative treatment: a prospective multicenter comparison to contrast-enhanced computed tomography”
Dong Ho Lee
Clinical and Molecular Hepatology.2026; 32(2): e251. CrossRef
Beyond diagnostic accuracy: Economic and clinical considerations for NC-MRI in late HCC recurrence surveillance: Letter to the editor on “Non-contrast magnetic resonance imaging for detection of late recurrent hepatocellular carcinoma after curative treat
Qi-Feng Chen, Sui-Xing Zhong, Ming Zhao
Clinical and Molecular Hepatology.2026; 32(2): e175. CrossRef
Interreader Agreement for Individual Ancillary Features in LI-RADS CT/MRI Version 2018: A Systematic Review and Meta-Analysis
Yong Jun Jung, Sang Hyun Choi, Subin Heo, Dong Hwan Kim, Suk Kim, Seung Baek Hong
American Journal of Roentgenology.2026;[Epub] CrossRef
HCC surveillance after curative treatment: A new frontier for abbreviated MRI: Editorial on “Non-contrast magnetic resonance imaging for detection of late recurrent hepatocellular carcinoma after curative treatment: a prospective multicenter comparison to
Hyungjin Rhee, Jin-Young Choi
Clinical and Molecular Hepatology.2026; 32(2): 939. CrossRef
Revisiting the role of non-contrast MRI in recurrent HCC: Bridging diagnostic performance and real-world applicability: Letter to the editor on “Non-contrast MRI for detection of late recurrent hepatocellular carcinoma after curative treatment: A prospect
Lu Sun, Xin Zhang
Clinical and Molecular Hepatology.2026; 32(2): e172. CrossRef
Multicentre prospective trial of abbreviated MRI using gadoxetic acid versus CT for detection of late recurrent HCC (AMRICT): study protocol
Hyo Jung Park, Dong Ho Lee, Won Chang, Hae Young Kim, Dong Hwan Kim, Won-Mook Choi, Sung Won Chung, Jonggi Choi, Danbi Lee, Ju Hyun Shim, Han Chu Lee, Young-Suk Lim, Seon-Ok Kim, Amit G Singal, So Yeon Kim
BMJ Open.2026; 16(4): e116809. CrossRef
The Use of Non‐Contrast Abbreviated MRI for the Detection of Recurrent Hepatocellular Carcinoma in Postoperative Surveillance
Jianwei Chen, Yuemin Zhu, Dechun Zheng, Liting Wen, Juyi Wu, Qiuyuan Yue, Zhuting Fang
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Mohammad Jarrah, Mohammed Al-Hasan, Mariadelcarmen Yanez, Maria V. Yow, Eunice Amador, Diya Kar, Fouzia Ahmed, Nicole E. Rich, Sneha Deodhar, Jenna Bedrava, Claire Chen, Amit G. Singal
Cancers.2026; 18(16): 2711. CrossRef
Visualization quality and effectiveness of noncontrast-abbreviated magnetic resonance imaging for hepatocellular carcinoma surveillance in cirrhotic patients with ultrasound visualization score C
Hyun Kyung Yang, Sunyoung Lee, Min Young Lee, Boryeong Jeong, Eunju Kim, Jeong Hee Yoon
European Radiology.2026;[Epub] CrossRef
Performance of GAAD and GALAD Biomarker Panels for HCC Detection in Patients with MASLD or ALD Cirrhosis
Mohammad Jarrah, Sneha Deodhar, Lisa Quirk, Mohammed Al-Hasan, Ashish Sharma, Guruveer Bhamra, Julia Terrell, Fasiha Kanwal, Yujin Hoshida, Nicole E. Rich, Purva Gopal, Amit G. Singal
Cancers.2025; 17(23): 3835. CrossRef

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239 Download
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Review

Liver fibrosis, cirrhosis, and portal hypertension

Hepatorenal syndrome: Current concepts and future perspectives: Chan-Young Jung, Jai Won Chang; Clin Mol Hepatol 2023;29(4):891-908.
Published online April 13, 2023; DOI: https://doi.org/10.3350/cmh.2023.0024

Abstract
PDF

Hepatorenal syndrome (HRS), a progressive but potentially reversible deterioration of kidney function, remains a major complication in patients with advanced cirrhosis, often leading to death before liver transplantation (LT). Recent updates in the pathophysiology, definition, and classification of HRS have led to a complete revision of the nomenclature and diagnostic criteria for HRS type 1, which was renamed HRS-acute kidney injury (AKI). HRS is characterized by severe impairment of kidney function due to increased splanchnic blood flow, activation of several vasoconstriction factors, severe vasoconstriction of the renal arteries in the absence of kidney histologic abnormalities, nitric oxide dysfunction, and systemic inflammation. Diagnosis of HRS remains a challenge because of the lack of specific diagnostic biomarkers that accurately distinguishes structural from functional AKI, and mainly involves the differential diagnosis from other forms of AKI, particularly acute tubular necrosis. The optimal treatment of HRS is LT. While awaiting LT, treatment options include vasoconstrictor drugs to counteract splanchnic arterial vasodilation and plasma volume expansion by intravenous albumin infusion. In patients with HRS unresponsive to pharmacological treatment and with conventional indications for kidney replacement therapy (KRT), such as volume overload, uremia, or electrolyte imbalances, KRT may be applied as a bridging therapy to transplantation. Other interventions, such as transjugular intrahepatic portosystemic shunt, and artificial liver support systems have a very limited role in improving outcomes in HRS. Although recently developed novel therapies have potential to improve outcomes of patients with HRS, further studies are warranted to validate the efficacy of these novel agents.

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1,588 Download
23 Web of Science
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Case Report

Viral hepatitis

Pure red-cell aplasia and autoimmune hemolytic anemia in a patient with acute hepatitis A: Hyo Jeong Chang, Dong Hyun Sinn, Sung Gyun Cho, Tae Hoon Oh, Tae Joo Jeon, Won Chang Shin, Won Choong Choi; Clin Mol Hepatol 2014;20(2):204-207.
Published online June 30, 2014; DOI: https://doi.org/10.3350/cmh.2014.20.2.204

Abstract
PDF

Pure red cell aplasia (PRCA) and autoimmune hemolytic anemia (AIHA) have rarely been reported as an extrahepatic manifestation of acute hepatitis A (AHA). We report herein a case of AHA complicated by both PRCA and AIHA. A 49-year-old female with a diagnosis of AHA presented with severe anemia (hemoglobin level, 6.9 g/dL) during her clinical course. A diagnostic workup revealed AIHA and PRCA as the cause of the anemia. The patient was treated with an initial transfusion and corticosteroid therapy. Her anemia and liver function test were completely recovered by 9 months after the initial presentation. We review the clinical features and therapeutic strategies for this rare case of extrahepatic manifestation of AHA.

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