Clinical and Molecular Hepatology

"MRI"

Reply to Correspondence

Reply to correspondence 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”: Qi-Feng Chen, Sui-Xing Zhong, Xiong-Ying Jiang, Ming Zhao; Clin Mol Hepatol 2026;32(3):e441-e444.
Published online September 23, 2025; DOI: https://doi.org/10.3350/cmh.2025.1033

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Research Letter

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; Clin Mol Hepatol 2026;32(1):e34-e37.
Published online September 17, 2025; DOI: https://doi.org/10.3350/cmh.2025.0927

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Correspondence

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; Clin Mol Hepatol 2026;32(3):e402-e404.
Published online September 1, 2025; DOI: https://doi.org/10.3350/cmh.2025.0945

Citations

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Reply to correspondence 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”
Qi-Feng Chen, Sui-Xing Zhong, Xiong-Ying Jiang, Ming Zhao
Clinical and Molecular Hepatology.2026; 32(3): e441. CrossRef

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Letters to the Editor

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 treatment: a prospective multicenter comparison to contrast-enhanced computed tomography”: Qi-Feng Chen, Sui-Xing Zhong, Ming Zhao; Clin Mol Hepatol 2026;32(2):e175-e178.
Published online August 19, 2025; DOI: https://doi.org/10.3350/cmh.2025.0769

Citations

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Hepatocellular carcinoma surveillance: a health economic evaluation
Qi-Feng Chen, Xiong-Ying Jiang, Song Chen, Jiongliang Wang, Ming Zhao
Clinical and Molecular Hepatology.2026; 32(2): 536. CrossRef
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(3): e402. CrossRef
Reply to correspondence 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”
Qi-Feng Chen, Sui-Xing Zhong, Xiong-Ying Jiang, Ming Zhao
Clinical and Molecular Hepatology.2026; 32(3): e441. CrossRef

3,166 View
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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 prospective multicenter comparison to contrast-enhanced CT”: Lu Sun, Xin Zhang; Clin Mol Hepatol 2026;32(2):e172-e174.
Published online July 21, 2025; DOI: https://doi.org/10.3350/cmh.2025.0683

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Citations to this article as recorded by

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

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Original Articles

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
Clinical and Molecular Hepatology.2026; 32(2): e221. CrossRef
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
Journal of Magnetic Resonance Imaging.2026; 64(3): 722. CrossRef
Performance of ASAP, LG2m, and GP73 for HCC Detection in Patients with Cirrhosis
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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Steatotic liver disease

Bariatric intervention improves metabolic dysfunction-associated steatohepatitis in patients with obesity: A systematic review and meta-analysis: Juchul Hwang, Hyeyoung Hwang, Hyunjae Shin, Bo Hyun Kim, Seong Hee Kang, Jeong-Ju Yoo, Mi Young Choi, Dong eun Lee, Dae Won Jun, Yuri Cho; Clin Mol Hepatol 2024;30(3):561-576.
Published online June 3, 2024; DOI: https://doi.org/10.3350/cmh.2023.0384

Background/Aims
Bariatric intervention has been reported to be an effective way to improve metabolic dysfunction-associated steatotic liver disease (MASLD) in obese individuals. The current systemic review aimed to assess the changes in MRI-determined hepatic proton density fat fraction (MRI-PDFF) and nonalcoholic fatty liver disease activity score (NAS) after bariatric surgery or intragastric balloon/gastric banding in MASLD patients with obesity.
Methods
We searched various databases including PubMed, OVID Medline, EMBASE, and Cochrane Library. Primary outcomes were the changes in intrahepatic fat on MRI-PDFF and histologic features of metabolic dysfunction-associated steatohepatitis (MASH).
Results
Thirty studies with a total of 3,134 patients were selected for meta-analysis. Bariatric intervention significantly reduced BMI (ratio of means, 0.79) and showed 72% reduction of intrahepatic fat on MRI-PDFF at 6 months after bariatric intervention (ratio of means, 0.28). Eight studies revealed that NAS was reduced by 60% at 3–6 months compared to baseline, 40% at 12–24 months, and 50% at 36–60 months. Nineteen studies revealed that the proportion of patients with steatosis decreased by 44% at 3–6 months, 37% at 12–24 months, and 29% at 36–60 months; lobular inflammation by 36% at 12–24 months and 51% at 36–60 months; ballooning degeneration by 38% at 12–24 months; significant fibrosis (≥F2) by 18% at 12–24 months and by 17% at 36–60 months after intervention.
Conclusions
Bariatric intervention significantly improved MRI-PDFF and histologic features of MASH in patients with obesity. Bariatric intervention might be the effective alternative treatment option for patients with MASLD who do not respond to lifestyle modification or medical treatment.

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Letter to the Editor

Artificial intelligence, epidemiology, methodology, or others

Letter regarding “Evidence-based hyponatremia management in liver disease”: Daphne J. Theodorou, Stavroula J. Theodorou, Ioannis V. Mitselos; Clin Mol Hepatol 2023;29(4):1043-1045.
Published online July 5, 2023; DOI: https://doi.org/10.3350/cmh.2023.0204

Citations

Citations to this article as recorded by

Correspondence on Letter regarding “Evidence-based hyponatremia management in liver disease”
Ji Young Ryu, Seon Ha Baek, Sejoong Kim
Clinical and Molecular Hepatology.2023; 29(4): 1048. CrossRef

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Editorial

Hepatic neoplasm

Surveillance of hepatocellular carcinoma: is only ultrasound enough?: Woo Kyoung Jeong; Clin Mol Hepatol 2017;23(3):222-223.
Published online September 19, 2017; DOI: https://doi.org/10.3350/cmh.2017.0046

Citations

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World Journal of Gastroenterology.2022; 28(29): 3917. CrossRef
Annual contrast-enhanced magnetic resonance imaging is highly effective in the surveillance of hepatocellular carcinoma among cirrhotic patients
Coskun Ozer Demirtas, Feyza Gunduz, Davut Tuney, Feyyaz Baltacioglu, Haluk Tarik Kani, Onur Bugdayci, Yesim Ozen Alahdab, Osman Cavit Ozdogan
European Journal of Gastroenterology & Hepatology.2020; 32(4): 517. CrossRef
Non-enhanced magnetic resonance as a surveillance tool for hepatocellular carcinoma: Many unresolved issues
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Exosomal microRNA‐4661‐5p–based serum panel as a potential diagnostic biomarker for early‐stage hepatocellular carcinoma
Hyo Jung Cho, Geum Ok Baek, Chul Won Seo, Hye Ri Ahn, Suna Sung, Ju A Son, Soon Sun Kim, Sung Won Cho, Jeong Won Jang, Suk Woo Nam, Jae Youn Cheong, Jung Woo Eun
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Joint Consensus Statement of the Indian National Association for Study of the Liver and Indian Radiological and Imaging Association for the Diagnosis and Imaging of Hepatocellular Carcinoma Incorporating Liver Imaging Reporting and Data System
Sonal Krishan, Radha K. Dhiman, Navin Kalra, Raju Sharma, Sanjay S. Baijal, Anil Arora, Ajay Gulati, Anu Eapan, Ashish Verma, Shyam Keshava, Amar Mukund, S. Deva, Ravi Chaudhary, Karthick Ganesan, Sunil Taneja, Ujjwal Gorsi, Shivanand Gamanagatti, Kumble
Journal of Clinical and Experimental Hepatology.2019; 9(5): 625. CrossRef

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Liver Imagings

Hepatic neoplasm

Intraductal malignant tumors in the liver mimicking cholangiocarcinoma: Imaging features for differential diagnosis: Ah Yeong Kim, Woo Kyoung Jeong; Clin Mol Hepatol 2016;22(1):192-197.
Published online March 28, 2016; DOI: https://doi.org/10.3350/cmh.2016.22.1.192

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Hepatic neoplasm

Magnetic resonance imaging following treatment of advanced hepatocellular carcinoma with sorafenib: Joon-Il Choi, David K Imagawa, Priya Bhosale, Puneet Bhargava, Temel Tirkes, Tara E Seery, Chandana Lall; Clin Mol Hepatol 2014;20(2):218-222.
Published online June 30, 2014; DOI: https://doi.org/10.3350/cmh.2014.20.2.218

Abstract
PDF

Hepatocellular carcinomas are highly vascular tumors, showing progressive hypervascularity by the process of neoangiogenesis. Tumor angiogenesis is critical for tumor growth as well as metastatic spread therefore, imaging and quantification of tumor neo-angiogenesis is essential for monitoring response to targeted therapies and predicting disease progression. Sorafenib is a molecular targeting agent used for treating hypervascular tumors. This drug is now the standard of care in treatment of patients with advanced hepatocellular carcinoma. Due to its anti-angiogenic and anti-proliferative actions, imaging findings following treatment with Sorafenib are quite distinct when compared to conventional chemotherapeutic agents. Liver MRI is a widely adopted imaging modality for assessing treatment response in hepatocellular carcinoma and imaging features may reflect pathophysiological changes within the tumor. In this mini-review, we will discuss MRI findings after Sorafenib treatment in hepatocellular carcinoma and review the feasibility of MRI as an early biomarker in differentiating responders from non-responders after treatment with molecular targeting agents.

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Infectious liver disease

Hepatic abscess mimicking hepatocellular carcinoma in a patient with alcoholic liver disease: Jin Woong Kim, Sang Soo Shin, Suk Hee Heo, Hyo Soon Lim, Young Hoe Hur, Jo Heon Kim; Clin Mol Hepatol 2013;19(4):431-434.
Published online December 28, 2013; DOI: https://doi.org/10.3350/cmh.2013.19.4.431

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Maligniteyi Taklit Eden Piyojenik Karaciğer Apsesi: Gereksiz Hepatektominin Önlenmesinde İntraoperatif Ultrasonografinin Önemi
Yacob Ledamo Habeş, Ahmet Murat Sendil
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A Pyogenic Liver Abscess Masquerading as Advanced Hepatocellular Carcinoma: Diagnostic Pitfalls of LI-RADS 5 in a Non-Cirrhotic Patient and Vascular Complications of Percutaneous Drainage
Finly Septianto, Ummi Maimunah
Gastrointestinal Disorders.2026; 8(3): 53. CrossRef
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Problematic lesions in cirrhotic liver mimicking hepatocellular carcinoma
Myeong-Jin Kim, Sunyoung Lee, Chansik An
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Hepatocellular carcinoma disguised as liver abscesses
Jasmine Gowarty, Arshad Ghauri, George Martinez, Angela L. Birdwell
Baylor University Medical Center Proceedings.2018; 31(2): 222. CrossRef

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Crossref

MR imaging of hepatic lymphangioma: Woo Jung Choi, Woo Kyoung Jeong, Yongsoo Kim, Jinoo Kim, Ju Yeon Pyo, Young Ha Oh; Korean J Hepatol 2012;18(1):101-104.
Published online March 22, 2012; DOI: https://doi.org/10.3350/kjhep.2012.18.1.101

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Case Report

A Case of Liver Abscess Associated with Fascioliasis Diagnosed by MRI: Jung Ho Shon,Kwang Bum Cho,Jae Seok Hwang,Young Woo Kang,Jung Wook Hur,Sung Hoon Ahn,Soong Kook Park; Korean J Hepatol 2001;7(1):90-94.

Abstract
PDF

Fascioliasis is a zoonotic helminthiasis caused by Fasciola hepatica, the sheep liver fluke. Humans are accidental hosts in the life cycle of the parasite. They are infected by the ingestion of water or raw aquatic vegetables contaminated with the metacercaria. The diagnosis of fascioliasis is based on clinical symptoms, absolute eosinophilia, serologic test (ELISA), radiologic finding, and presence of eggs in the feces or duodenal fluid. Recently, some radiologists have been reporting specific findings of fascioliasis by MRI. We report a case of liver abscess associated with fascioliasis diagnosed by MRI.(Korean J Hepatol 2001;7:90-94)

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Original Article

The Clinical Usefulness of SPIO-MRI in Detection and Staging of Hepatocellular Carcinoma: Kwang Cheol Koh, M.D., Hong Joo Kim, M.D., Won Hyeok Choe, M.D., Gyung Soo Chae, M.D., Moon Seok Choi, M.D., Joon Hyoek Lee, M.D., Seung Woon Paik, M.D., Jong Chul Rhee, M.D. and Kyu Wan Choi, M.D.; Korean J Hepatol 2003;9(1):17-24.

Abstract
PDF

Background/Aims
It is still unclear whether Super Paramagnetic Iron Oxide-Magnetic Resonance Imaging (SPIO-MRI) is a clinically useful imaging modality for patients with hepatocellular carcinoma (HCC). This study searched for the clinical usefulness and limitations of SPIO-MRI with respect to tumor detection capacity, false positive and negative rate, and early recurrence rate. Methods: From December 1999 to February 2001, 218 patients who were surgical candidates by 3-phase dynamic helical CT (3dHCT) were enrolled. We reviewed the medical records and radiologic findings, retrospectively, and postulated the post-operative pathologic findings and the early recurrences within 3 months as the standards for the true positive lesion. Results: The mean number of nodules detected by SPIO-MRI was significantly more numerous than that of 3dHCT (p<0.01). Modifications of treatment strategy due to the discordant findings between SPIO-MRI and 3dHCT for tumor resectability were observed in 22 (10.1%) out of 218 patients. Early recurrences were observed in 10 patients (7.8%). The false positive and negative rates of SPIO-MRI were 6.3% and 13.3%, respectively. Conclusions: We demonstrated that the tumor detection rate of SPIO-MRI was better than that of 3dHCT. Given the relatively acceptable false positive and negative rates, SPIO-MRI could be an appropriate preoperative imaging modality for patients with HCCs.(Korean J Hepatol 2002;9:17-24)