Updates in Abbreviated MRI-Based HCC Surveillance

Magnetic resonance imaging has gained increasing attention as a surveillance tool for hepatocellular carcinoma in high-risk populations due to its superior sensitivity for detecting early-stage tumors compared with ultrasound. However, the widespread use of complete contrast-enhanced MRI in routine surveillance has been limited by its long acquisition time and high cost. Abbreviated magnetic resonance imaging has emerged as a practical and effective alternative, offering improved sensitivity over ultrasound while reducing scan time and resource use compared with complete magnetic resonance imaging. Abbreviated magnetic resonance imaging protocols include only the sequences most essential for hepatocellular carcinoma detection and are generally classified into three categories: hepatobiliary-phase abbreviated magnetic resonance imaging using gadoxetic acid, dynamic contrast-enhanced abbreviated magnetic resonance imaging, and noncontrast abbreviated magnetic resonance imaging. This review summarizes the diagnostic performance, clinical applicability, and advantages and limitations of each abbreviated magnetic resonance imaging approach, as well as strategies for interpretation and reporting. Recent prospective studies have provided high-level evidence supporting the clinical utility of abbreviated magnetic resonance imaging, reinforcing its potential role in hepatocellular carcinoma surveillance for high-risk patients. To maximize its effectiveness, careful patient selection and consideration of cost-effectiveness are essential. A risk-adapted surveillance tailored to individual patient characteristics may represent the most efficient strategy for integrating abbreviated magnetic resonance imaging into routine practice, which this review also explores.