The Detection of Small Early Liver Cancer With Natural History Follow up

Inclusion criteria

• Participant is willing and able to give informed consent for participation in the study.
• Male or Female aged 18 years or above.
• Diagnosed with small HCC (Barcelona Clinic Liver Cancer Staging Criteria (BCLC) stage 0/A; 1-3 nodules <3cm, preserved liver function, performance status 0) with liver cirrhosis from any aetiology
• Diagnosed with small HCC (as above) and without cirrhosis
• Diagnosis of small HCC shown or confirmed within 3 months of study Visit 1
• Patients with a diagnosis of HCC that was fully ablated or resected more than 6 months ago and now presenting with a new diagnosis of HCC in a different site in the liver may be included in the study
• Histological confirmation is required to establish the diagnosis of HCC in patients without cirrhosis (imaging alone is not considered sufficient to establish the diagnosis of HCC).

Exclusion criteria

• Patients judged by the investigator to be unsuitable for inclusion in the study (e.g. where the investigator feels that the participant will not be able to comply with the study procedures)
• HCC with liver cirrhosis at BCLC stage B/C
• Patients who have had a previous liver transplant (note, it is permitted to enrol patients on the liver transplant waiting list if they fulfil all inclusion/exclusion criteria)
• Participants of the Pearl study
• Patients who have had a previous diagnosis of HCC followed by therapy, and now have a recurrence at the same site in the liver
• Patients who have received HCC specific therapy 3 months prior to study visit 1 (including resection, ablation [microwave/radiofrequency]), transarterial chemoembolization [TACE], select internal radiation therapy [SIRT] or stereotactic body radiation therapy [SBRT] 3, chemotherapy, immune modulators and other experimental therapies).

Exclusion criteria

for Imaging Subgroup

• Any contra-indication to Magnetic Resonance Imaging (MRI) (e.g. claustrophobia, metal implants/fragments, implants, pregnancy, other conditions the scanner operator deems unsafe for MR scanning).