What is an optimal MRI screening strategy for hepatocellular carcinoma (HCC)?
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Screening for HCC is controversial. An accepted screening strategy includes a combination of AFP and liver ultrasound every 6-12 months, but either and both tests have been criticized in terms of sensitivity and specificity (ref 1). MRI would be an excellent screening test with its high sensitivity and specifity, but is too expensive to use as a mass screening tool. The effectiveness of screening has also been called into question by some, since 20-50% of HCCs present in persons who were not known to have cirrhosis (ref 2).