{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T11:04:53Z","timestamp":1792839893140,"version":"4.5.0"},"reference-count":33,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","license":[{"start":{"date-parts":[[2023,3,1]],"date-time":"2023-03-01T00:00:00Z","timestamp":1677628800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/ http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:sec>\n            <jats:title>Background:<\/jats:title>\n            <jats:p>Patients with cirrhosis and subcentimeter lesions on liver ultrasound are recommended to undergo short-interval follow-up ultrasound because of the presumed low risk of primary liver cancer (PLC).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Aims:<\/jats:title>\n            <jats:p>The aim of this study is to characterize recall patterns and risk of PLC in patients with subcentimeter liver lesions on ultrasound.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods:<\/jats:title>\n            <jats:p>We conducted a multicenter retrospective cohort study among patients with cirrhosis or chronic hepatitis B infection who had subcentimeter ultrasound lesions between January 2017 and December 2019. We excluded patients with a history of PLC or concomitant lesions \u22651\u00a0cm in diameter. We used Kaplan Meier and multivariable Cox regression analyses to characterize time-to-PLC and factors associated with PLC, respectively.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results:<\/jats:title>\n            <jats:p>Of 746 eligible patients, most (66.0%) had a single observation, and the median diameter was 0.7\u00a0cm (interquartile range: 0.5\u20130.8\u00a0cm). Recall strategies varied, with only 27.8% of patients undergoing guideline-concordant ultrasound within 3\u20136 months. Over a median follow-up of 26 months, 42 patients developed PLC (39 HCC and 3 cholangiocarcinoma), yielding an incidence of 25.7 cases (95% CI, 6.2\u201347.0) per 1000 person-years, with 3.9% and 6.7% developing PLC at 2 and 3 years, respectively. Factors associated with time-to-PLC were baseline alpha-fetoprotein &gt;10\u00a0ng\/mL (HR: 4.01, 95% CI, 1.85\u20138.71), platelet count \u2264150 (HR: 4.90, 95% CI, 1.95\u201312.28), and Child-Pugh B cirrhosis (vs. Child-Pugh A: HR: 2.54, 95% CI, 1.27\u20135.08).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions:<\/jats:title>\n            <jats:p>Recall patterns for patients with subcentimeter liver lesions on ultrasound varied widely. The low risk of PLC in these patients supports short-interval ultrasound in 3\u20136 months, although diagnostic CT\/MRI may be warranted for high-risk subgroups such as those with elevated alpha-fetoprotein levels.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1097\/hc9.0000000000000073","type":"journal-article","created":{"date-parts":[[2023,3,7]],"date-time":"2023-03-07T19:40:17Z","timestamp":1678218017000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":33,"title":["Recall patterns and risk of primary liver cancer for subcentimeter ultrasound liver observations: a multicenter study"],"prefix":"10.1097","volume":"7","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1172-3971","authenticated-orcid":false,"given":"Amit G.","family":"Singal","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, UT Southwestern Medical Center, Dallas, Texas, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2652-0595","authenticated-orcid":false,"given":"T. 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