Evidence map›Paper›PMID 27862091›Full record

ArticleAlimentary pharmacology & therapeutics2017

Predictors of adequate ultrasound quality for hepatocellular carcinoma surveillance in patients with cirrhosis.

O Simmons, D T Fetzer, T Yokoo, J A Marrero, A Yopp, Y Kono, N D Parikh, T Browning, A G Singal

Registry-linked trialAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Alimentary pharmacology & therapeutics, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07010588 (Comparison of ultraSound, Abbreviated MRI witH and Without HBP aS mOdalities for HCC suRveillance in patienTs With High Risk), which is not on this map. Cited by 191 papers, 8 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
191citing papers in PubMed, 8 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT07010588 nanot yet recruitingnot on this mapstarted 2025, after this paper: background citation

Comparison of ultraSound, Abbreviated MRI witH and Without HBP aS mOdalities for HCC suRveillance in patienTs With High Risk: a Multi-centers, Randomized Controlled Open-label Trial

TypeinterventionalSponsorPeking University People's HospitalRan2025 to 2030Enrolled1,389ConditionsHepatocellular Carcinoma (HCC), Magnetic Resonance Imaging (MRI), Randomized Controlled TrialArmsnon-contrast abbreviated MRI (NC-AMRI), enhanced abbreviated MRI (E-AMRI)
3 · Its place in the literature

Who cites it

191 citing papers in PubMed, 8 syntheses or guidelines pooled it.

  1. Comparison of abbreviated MRI and ultrasonography in the detection of early hepatocellular carcinoma: a meta-analysis.Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico · 2026
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  15. Prediagnostic Plasma Metabolite Profiles and Prediction of Hepatocellular Carcinoma Risk: The Multiethnic Cohort.Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology · 2026
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131 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

9 authors.

O SimmonsDepartment of Internal Medicine, UT Southwestern Medical Center and Parkland Health and Hospital System, Dallas, TX, USA.
D T FetzerDepartment of Radiology, UT Southwestern Medical Center, Dallas, TX, USA.
T YokooDepartment of Radiology, UT Southwestern Medical Center, Dallas, TX, USA.
J A MarreroDepartment of Internal Medicine, UT Southwestern Medical Center and Parkland Health and Hospital System, Dallas, TX, USA.
A YoppDepartment of Surgery, UT Southwestern Medical Center, Dallas, TX, USA.
Y KonoDepartment of Internal Medicine, UC San Diego, San Diego, CA, USA.
N D ParikhDepartment of Internal Medicine, University of Michigan, Ann Arbor, MI, USA.
T BrowningDepartment of Radiology, UT Southwestern Medical Center, Dallas, TX, USA.
A G SingalDepartment of Internal Medicine, UT Southwestern Medical Center and Parkland Health and Hospital System, Dallas, TX, USA.

Funding

UT Southwestern Center of Patient-Centered Outcomes Research (PCOR)R24HS022418 · AHRQ · UT SOUTHWESTERN MEDICAL CENTER · PI HALM, ETHAN A · 2013 to 2017
$5.0M
AHRQ HHS R24 HS022418
6 · The paper itself

Abstract

backgroundAbdominal ultrasound fails to detect over one-fourth of hepatocellular carcinoma (HCC) at an early stage in patients with cirrhosis. Identifying patients in whom ultrasound is of inadequate quality can inform interventions to improve surveillance effectiveness.

aimTo evaluate and identify predictors of ultrasound quality in patients with cirrhosis.

methodsWe performed a retrospective cohort study among patients who underwent ultrasound examination for a cirrhosis-related indication between April 2015 and October 2015. Three fellowship-trained abdominal radiologists collectively reviewed all ultrasound exams and categorised exam quality as definitely adequate, likely adequate, likely inadequate and definitely inadequate to exclude liver lesions. We performed multivariable logistic regression to determine characteristics associated with inadequate ultrasound quality.

resultsAmong 941 patients, 191 (20.3%) ultrasounds were inadequate for excluding HCC- 134 definitely inadequate and 57 likely inadequate. In multivariable analysis, inadequate quality was associated with male gender (OR 1.68, 95% CI 1.14-2.48), body mass index category (OR 1.67, 95% CI 1.45-1.93), Child-Pugh B or C cirrhosis (OR 1.93, 95% CI 1.32-2.81), alcohol-related cirrhosis (OR 2.11, 95% CI 1.33-3.37), NASH cirrhosis (OR 2.87, 95% CI 1.71-4.80), and in-patient status (OR 1.55, 95% CI 1.01-2.37). Ultrasounds were inadequate in over one-third of patients with Child-Pugh C cirrhosis, BMI >35, or NASH cirrhosis.

conclusionsOne in five ultrasounds in patients with cirrhosis are inadequate for exclusion of HCC, which can contribute to surveillance failure. Alternative surveillance modalities are needed in subgroups prone to inadequate ultrasounds including obese patients, those with Child Pugh B or C cirrhosis, and those with alcohol- or NASH-related cirrhosis.

Indexed as

Population SurveillanceAdultAgedCarcinoma, HepatocellularCohort StudiesFemaleHumansLiver CirrhosisLiver NeoplasmsMaleMiddle AgedPredictive Value of TestsRetrospective StudiesUltrasonography

Identifiers

PMID27862091
PMCPMC7207219

What OpenQuestion holds

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.