Abbreviated MRI for Hepatocellular Carcinoma Screening: A Comprehensive Review

Purpose of Review: Hepatocellular carcinoma (HCC) is a leading cause of cancer mortality worldwide. Effective surveillance improves patient outcomes, but the standard modality—ultrasound (US) with or without alpha-fetoprotein (AFP)—has suboptimal sensitivity. This review evaluates the role of abbreviated MRI (AMRI) as an alternative HCC screening tool, highlighting its diagnostic performance, protocol variation, and implementation challenges. Recent Findings: AMRI offers higher sensitivity (84–87%) than US (50–65%) for HCC detection, particularly in high-risk patients. Among AMRI protocols, non-contrast AMRI shows the highest specificity, while contrast-enhanced AMRI improves sensitivity for early-stage HCC. Ongoing trials are evaluating its role in routine surveillance and cost-effectiveness. Summary: AMRI is a promising alternative to US for HCC surveillance, achieving superior sensitivity, especially for early-stage tumors, with shorter scan times. However, protocol variability, cost, and accessibility remain major challenges. Large-scale trials may support its clinical effectiveness and broader adoption in high-risk populations.