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
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
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
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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
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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
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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
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