What is the best choice of surveillance for hepatocellular carcinoma in a patient with hepatitis B and cirrhosis?

The best choice for surveillance of hepatocellular carcinoma (HCC) in a patient with hepatitis B and cirrhosis is liver ultrasound every 6 months. This frequency is recommended because patients with chronic hepatitis B and cirrhosis are at significantly increased risk for developing HCC, and early detection is crucial for improving survival outcomes.

Liver ultrasounds are effective for monitoring changes in liver architecture that may indicate the presence of tumors, and the 6-month interval allows for timely identification of any new masses. This is particularly important as HCC can develop and progress relatively quickly in individuals with cirrhosis.

Using ultrasound for surveillance is also preferred because it is non-invasive, does not involve radiation exposure, and is cost-effective. The guidelines from various health organizations support this approach for patients at high risk, including those with chronic liver diseases such as hepatitis B.

In contrast, less frequent imaging, such as annual CT scans or ultrasounds, may delay the diagnosis of HCC and miss the window for curative treatments. CT scans, although useful in certain scenarios, are typically not used for routine surveillance due to cost considerations, radiation exposure, and the specific recommendation for ultrasound in high-risk patients.