Abbreviated Magnetic Resonance Imaging vs ultrasound surveillance for liver cancer detection in people at high risk of developing liver cancer

People with any condition that affects the liver over a long period of time can develop cirrhosis. Conditions that can lead to cirrhosis include alcohol excess, liver steatosis (lipid or fat accumulation in the liver) and infection with hepatitis B and C. One concern about people with cirrhosis is that they are at increased risk of developing liver cancer. People with cirrhosis are recommended to have an ultrasound scan (USS) every 6 months (surveillance) so that if a cancer develops, it is diagnosed at an early stage when it can be cured. However, ultrasound can miss early cancers even in people having scans every 6 months. Furthermore, the risk of cancer is not uniform among people with cirrhosis. For example, people with more advanced cirrhosis and those with cirrhosis from hepatitis B are at higher risk. It is therefore possible that better tests than ultrasound are needed for people with cirrhosis who are at particularly high risk of cancer. Computed tomography (CT) and Magnetic Resonance Imaging (MRI) scans with dye injection (contrast) are used for liver cancer diagnosis. However, they cannot be done every 6 months because of costs, capacity and toxicity from high CT radiation doses, and MRI contrast accumulation in the brain with repeated MRI contrast injections. MRI scans without contrast are not toxic, cheaper and could be done in 20 minutes, so could be done every 6 months. In our experience, MRI without contrast may raise suspicion of liver cancer in cases missed by ultrasound, so it could be used for surveillance instead. In this study we want to find out if it is feasible to use a quick MRI without contrast as surveillance for hepatocellular cancer (HCC) in people at high risk of liver cancer due to cirrhosis and to compare this MRI with ultrasound.