The Effectiveness of Ultrasound Surveillance for Hepatocellular Carcinoma in a Canadian Centre and Determinants of Its Success
Bibliographic record
Abstract
BACKGROUND: The effectiveness of surveillance for hepatocellular carcinoma (HCC) using ultrasound (US) in North America has been questioned due to the predominance of patients of Caucasian ethnicity and larger body habitus. OBJECTIVE: To determine the effectiveness of US surveillance for HCC in a Canadian hepatobiliary centre and to identify independent variables associated with early detection of tumour(s). METHODS: A retrospective review of patients with first HCC in a US surveillance population at the authors' hospital yielded 201 patients (over a 10.5-year period). Patients were categorized into three groups: regular surveillance (frequency of surveillance ≤12 months [n=109]); irregular surveillance (frequency of surveillance >12 months [n=38]); or first surveillance (tumour detected on first scan [n=54]). The Milan criteria for transplantation and Barcelona Clinic Liver Cancer (BCLC) staging system were used as outcome measures. Effective surveillance was defined as tumour detection within Milan criteria or curative BCLC stages 0 and A; its association with multiple patient- and disease-related variables was tested. RESULTS: When using the Milan criteria as outcome, 84 of 109 (77%) regular surveillance patients, 23 of 38 (61%) irregular surveillance patients and 40 of 54 (74%) first surveillance patients had tumours meeting the transplantation criteria. The difference between regular and irregular surveillance was statistically significant (P=0.03). When using the BCLC staging system, 87 of 109 (80%) regular surveillance patients, 26 of 38 (68%) irregular surveillance patients and 41 of 54 (76%) first surveillance patients had their tumours detected in BCLC curative stages (0 and A; P=0.11). Regular surveillance was the only variable significantly associated with detection of tumour(s) within the Milan criteria (OR 2.76 [95% CI 1.10 to 6.88]). Tumours detected more recently were more likely to be <2 cm in size (BCLC stage 0; OR 2.38 [95% CI 1.07 to 5.31]). CONCLUSION: A high rate of HCC surveillance success was achieved using US alone when performed regularly in a specialized hepatobiliary centre.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.012 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".