SynthesisGastroenterology2018
Surveillance Imaging and Alpha Fetoprotein for Early Detection of Hepatocellular Carcinoma in Patients With Cirrhosis: A Meta-analysis.
Synthesis in Gastroenterology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 4 registered trials, which are not on this map. Cited by 707 papers, 8 of them syntheses that pooled it.
What it found
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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.
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.
HCC Surveillance: Comparison of Abbreviated Non-contrast MRI and Ultrasound Surveillance in Cirrhotic Patients With Suboptimal Ultrasound Visualisation
Utility of Abbreviated Magnetic Resonance Imaging as a Screening Tool for Hepatocellular Carcinoma in Cirrhotic Patients
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
A Prospective, Interventional, Longitudinal APAC Study Evaluating Clinical Utility of GAAD Score for Detection of Hepatocellular Carcinoma in a High-risk APAC Patient Population
Who cites it
707 citing papers in PubMed, 8 syntheses or guidelines pooled it.
- APASL clinical practice guidelines on the management of chronic hepatitis B infection: a 2026 update.Hepatology international · 2026Guideline
- Clinical Practice Guidelines for Adult MASLD in Bosnia and Herzegovina: National Recommendations for Diagnosis, Risk Stratification, and Treatment.Acta medica academica · 2026Guideline
- Diagnostic accuracy of surveillance tests for hepatocellular carcinoma in cirrhosis: a systematic review and network meta-analysis.BMJ open gastroenterology · 2026Pooled it
- AGA Clinical Practice Update on Risk Stratification and Emerging Surveillance Strategies for Hepatocellular Carcinoma: Expert Review.Gastroenterology · 2026Guideline
- Circulating tumour DNA for a minimal residual disease assessment and recurrence risk in hepatocellular carcinoma: a systematic review and meta-analysis.British journal of cancer · 2026Pooled it
- Prevention, surveillance, and early detection of hepatocellular carcinoma - a Brazilian multidisciplinary consensus.Arquivos brasileiros de cirurgia digestiva : ABCD = Brazilian archives of digestive surgery · 2026Guideline
- Recent Advancements in Known and Emerging Risk Factors of Hepatocellular Carcinoma.Cancer medicine · 2025Pooled it
- Comparison of models to predict incident chronic liver disease: a systematic review and external validation in Chinese adults.BMC medicine · 2024Pooled it
- Impact of Add-On Hepatobiliary Abbreviated Magnetic Resonance Imaging on Ultrasound Hepatoma Surveillance for Liver Cirrhosis- a Randomized Study.The Kaohsiung journal of medical sciences · 2026Trial
- A Phase 3 Biomarker Validation of GALAD for the Detection of Hepatocellular Carcinoma in Cirrhosis.Gastroenterology · 2025Trial
- A sequentially activated afterglow probe for AND-gated imaging of alpha-fetoprotein in hepatocellular carcinoma.Bioactive materials · 2027Article
- Development and validation of a digital PCR assay targeting plasmaEpigenetics · 2026Article
- Cell-free DNA methylation markers in the diagnosis of hepatitis B virus-related- hepatocellular carcinoma: a review.Molecular biology reports · 2026Review
- Global disparities in hepatocellular carcinoma care: insights from the ESGAR Global Abdominal Imaging Forum.European radiology · 2026Article
- Glypican-3-targeted bioconjugates for hepatocellular carcinoma: design, engineering, and translational applications.Medicinal chemistry research : an international journal for rapid communications on design and mechanisms of action of biologically active agents · 2026Review
- Urinary Volatile Organic Compounds as Non-Invasive Biomarkers to Distinguish Hepatocellular Carcinoma from Cirrhosis: A Multicentre Diagnostic Accuracy Study.Sensors (Basel, Switzerland) · 2026Observational
- The landscape of peripheral blood RNA modifications and its clinical implications for diagnosis of hepatocellular carcinoma.Cell communication and signaling : CCS · 2026Article
- Radiology considerations for the PREMIUM study: a multicenter randomized controlled trial of abbreviated MRI versus ultrasound for liver cancer screening in cirrhosis.Abdominal radiology (New York) · 2026Review
- Identification of a G-quadruplex-forming cell-free DNA fragment as a biomarker for the precise diagnosis of hepatocellular carcinoma.Chemical science · 2026Article
- Diagnostic performance of abbreviated MRI in surveillance of patients with hepatocellular carcinoma candidates for liver transplantation.La Radiologia medica · 2026Article
647 more citing papers are in PubMed but not listed here.
Corrections and comments
Authors and funding
8 authors.
Funding
Abstract
BACKGROUND &
aimsSociety guidelines differ in their recommendations for surveillance to detect early-stage hepatocellular carcinoma (HCC) in patients with cirrhosis. We compared the performance of surveillance imaging, with or without alpha fetoprotein (AFP), for early detection of HCC in patients with cirrhosis.
methodsTwo reviewers searched MEDLINE and SCOPUS from January 1990 through August 2016 to identify published sensitivity and specificity of surveillance strategies for overall and early detection of HCC. Pooled estimates were calculated and compared using the DerSimonian and Laird method for a random effects model. The study was conducted in accordance with Preferred Reporting Items for Systematic Review and Meta-analysis guidelines.
resultsThirty-two studies (comprising 13,367 patients) characterized sensitivity of imaging with or without AFP measurement for detection of HCC in patients with cirrhosis. Ultrasound detected any stage HCC with 84% sensitivity (95% confidence interval [CI] 76%-92%), but early-stage HCC with only 47% sensitivity (95% CI 33%-61%). In studies comparing ultrasound with vs without AFP measurement, ultrasound detected any stage HCC with a lower level of sensitivity than ultrasound plus AFP measurement (relative risk [RR] 0.88; 95% CI 0.83-0.93) and early-stage HCC with a lower level of sensitivity than ultrasound plus AFP measurement (RR 0.81; 95% CI 0.71-0.93). However, ultrasound alone detected HCC with a higher level of specificity than ultrasound plus AFP measurement (RR 1.08; 95% CI 1.05-1.09). Ultrasound with vs without AFP detected early-stage HCC with 63% sensitivity (95% CI 48%-75%) and 45% sensitivity (95% CI 30%-62%), respectively (P = .002). Only 4 studies evaluated computed tomography or magnetic resonance image-based surveillance, which detected HCC with 84% sensitivity (95% CI 70%-92%).
conclusionsWe found ultrasound alone has a low sensitivity to detect early stage HCC in patients with cirrhosis. Addition of AFP to ultrasound significantly increases sensitivity of early HCC detection in clinical practice.
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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.