Clinical Edge Journal Scan

Blind spots require attention during abdominal ultrasonography-based HCC surveillance


Key clinical point: Abdominal ultrasonography (US) blind spots affect the initially detected hepatocellular carcinoma (HCC) tumor size, treatment strategy, and overall survival (OS) in patients with HCC who undergo regular surveillance.

Major finding: A significantly higher proportion of HCC tumors >2 cm were detected in blind vs non-blind spots (60.3% vs 47.1%; P = .001), with most being treated with hepatectomy ( P < .001) vs radiofrequency ablation, respectively. Patients with HCC located in a blind spot in the US-detected vs US-missed group had a significantly better OS ( P = .008).

Study details: This retrospective study included 1289 patients who underwent 6-month interval surveillance using US and serum alpha-fetoprotein and were eventually diagnosed with single-nodular Barcelona Clinic Liver Cancer stage 0-A HCC that was detected (n = 1062) or missed (n = 227) by US.

Disclosures: This study was supported by a grant from the Medical Science Research Institute, Kyung Hee University Hospital at Gangdong, South Korea. The authors declared no conflicts of interest.

Source: Lee J, Park SB, et al. Impact of ultrasonographic blind spots for early-stage hepatocellular carcinoma during surveillance. PLoS One. 2022;17(9):e0274747 (Sep 16). Doi: 10.1371/journal.pone.0274747

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