Effectiveness of Ultrasound and AFP for HCC Screening

Ultrasound and alpha-fetoprotein (AFP) have long been cornerstones of hepatocellular carcinoma (HCC) screening in patients with cirrhosis. We have explored how ultrasound quality, operator variability, and patient characteristics influence effectiveness of ultrasound for early HCC detection. We have shown that ultrasound’s sensitivity is suboptimal, especially in patients with obesity or advanced liver disease. We also showed AFP, when used in combination with imaging, increases sensitivity for early-stage HCC, prompting its inclusion in guideline recommendations.