Evaluation of non-contrast enhanced magnetic resonance imaging compared to standard of care ultrasound as screening tests for hepatocellular cancer in patients with liver cirrhosis

We will recruit 300 people with cirrhosis who are at highest risk of liver cancer and due to have 6 monthly surveillance ultrasound scans of liver as part of routine care. Patients in our study will have an additional 6 monthly non-contrast MRI scan for 3 years (6 visits in total). If the ultrasound or the non-contrast MRI scan identifies a possible cancer, a contrast-enhanced MRI scan will be done for definitive diagnosis. All patients will have a contrast-enhanced MRI scan at the end of 3 years to ensure that no cancers were missed by either test. Patients will be asked to complete annual quality of life questionnaires and data will be collected from their medical notes. If we find MRI is feasible for 6-monthly surveillance in the NHS and superior to ultrasound for detecting early liver cancer, the likely next step will be to develop a larger study to evaluate these tests in all patients with liver cirrhosis and not just those at highest risk of liver cancer.