The role of three different contrast-enhanced, abbreviated MRI protocols as a screening tool of hepatocellular carcinoma in patients with chronic hepatitis C virus infection

Introduction
Our study aims to assess the role and diagnostic performance of 3 different contrast-enhanced, abbreviated magnetic resonance imaging (MRI) protocols as a screening tool of hepatocellular carcinoma (HCC).

Material and methods
Our retrospective study included 80 patients who were screened for HCC: 47 patients revealed 138 focal hepatic lesions. MRI examinations were performed including full CE-MRI protocols. The MRI was done on a 1.5 T machine. Then 3 different abbreviated contrast-enhanced MRI protocols were analysed separately. The standard dynamic contrast MRI and abbreviated protocols were evaluated following the LI-RADS 2018 lexicon diagnostic features.

Results
A considerable overall kappa (κ) agreement between the abbreviated 1, 2, and 3 protocols on LI-RADS classification was noted with κ = 0.865. There was almost perfect agreement between all abbreviated protocols and full standard protocol on LI-RADS classification, with κ = 0.890. As regards the κ agreement on LI-RADS classification, there was a considerable highest agreement between the abbreviated 1 protocol and the full standard protocol, with κ = 0.980. The abbreviated 1 and 2 protocols showed high diagnostic performance on LI-RADS classification of lesions, with 100% sensitivity, specificity, PPV, NPV, and accuracy, while the abbreviated 3 protocol showed a lesser but comparable sensitivity 96.9%, NPV 99.4, and accuracy 99.4%.

Conclusions
Abbreviated contrast-enhanced MRI protocols can be used as a screening tool for the detection of HCC, with high sensitivity, specificity, PPV, NPV, and accuracy close to the full protocol. There was a considerable highest agreement between the abbreviated 1 protocol and the full standard protocol. Subsequently, this protocol can be used as a standard protocol for screening high-risk patients.