ArticlePloS one2022
Impact of ultrasonographic blind spots for early-stage hepatocellular carcinoma during surveillance.
Article in PloS one, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed, 8 citations in OpenAlex.
- Clinical utility of 140-degree scan angle wide-view ultrasound for comprehensive liver and spleen imaging.Journal of ultrasound · 2026Article
- Comparison of ultrasound-detected and undetected hepatocellular carcinomas: a post-hoc, subgroup analysis from the MAGNUS-HCC surveillance trial.Ultrasonography (Seoul, Korea) · 2025Article
- Utility of fusion imaging for the evaluation of ultrasound quality in hepatocellular carcinoma surveillance.Ultrasonography (Seoul, Korea) · 2023Article
- Risk Factors for Early Recurrence After Radical Resection of Hepatocellular Carcinoma Based on Preoperative Contrast-Enhanced Ultrasound and Clinical Features.Technology in cancer research & treatmentArticle
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Authors and funding
4 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAbdominal ultrasonography (US) is the backbone of hepatocellular carcinoma (HCC) surveillance. Although previous studies have evaluated clinical factors related to surveillance failure, none have focused specifically on US blind spots.
methodsThis study included 1,289 patients who underwent 6 months intervals surveillance using US and serum alpha-fetoprotein (AFP) and were eventually diagnosed with single-nodular HCC. Patients were divided into US-detected group (n = 1,062) and US-missed group (HCC detected only by AFP ≥ 20ng/mL; n = 227). Blind spots consisted of four locations: hepatic dome, caudate lobe or around the inferior vena cava, <1 cm beneath the ribs, and the surface of the left lateral segment. Both groups were compared by HCC location, proportional distribution, treatment method, and overall survival.
resultsA higher proportion of HCCs were located within blind spots in the US-missed group than in the US-detected group (64.3% vs. 44.6%, P < 0.001). HCC ≥ 2 cm detected in blind spots was higher than in non-blind areas (60.3% vs. 47.1%, P = 0.001). Blind spot HCCs were more treated with surgery, whereas those located in a non-blind area were more treated with local ablation. Patients with an HCC located within a blind spot in the US-detected group had better overall survival than the same in the US-missed group (P = 0.008).
conclusionsUsing the current surveillance test, blind spots affected the initially detected HCC tumor size, applicability of the treatment modality, and overall survival. Physicians should pay attention to US blind spots when performing US-based HCC surveillance.
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