Can an 8 mm liver tumor be detected before routine surveillance finds it?
This real-world case from the CLiMB Trial illustrates the importance of detecting hepatocellular carcinoma (HCC) while lesions are still small.
Can an 8 mm liver tumor be detected before routine surveillance finds it?
This real-world case from the CLiMB Trial illustrates the importance of detecting hepatocellular carcinoma (HCC) while lesions are still small.
Case summary
| Setting | Routine HCC surveillance |
|---|---|
| Patient | High-risk patient with cirrhosis |
| Standard abdominal ultrasound | Performed; no lesion detected |
| HelioLiver® result | Blood test returned positive |
| Follow-up MRI | Identified an 8 mm hepatocellular carcinoma (HCC) |
| Stage | T1, while still within the curative treatment window |
What this case illustrates
This case illustrates one of the key findings from the CLiMB Trial:
- Ultrasound detected 0% of HCC lesions 2 cm or smaller during a single surveillance visit.
- HelioLiver® detected 28.6% of HCC lesions 2 cm or smaller, including tumors as small as 8 mm.
For patients at high risk of liver cancer, detecting HCC while lesions are still small may provide an opportunity for earlier intervention and potentially curative treatment.
Because in liver cancer, every millimeter matters.
- CLiMB Trial – A multi-analyte cfDNA-based blood test for early detection of hepatocellular carcinoma. Journal of Hepatology (2026). doi:10.1016/j.jhep.2026.04.012
About the CLiMB trial
CLiMB was a cross-sectional, prospective, blinded, multicenter validation study conducted across 42 clinical sites in the United States, evaluating the HelioLiver Dx test against abdominal ultrasound for the detection of hepatocellular carcinoma in adults with cirrhosis. Multiphasic MRI served as the reference standard. The HelioLiver Dx test met prespecified co-primary endpoints for superior sensitivity and non-inferior specificity compared to ultrasound.
Enrolled vs. evaluable. The prospective CLiMB study enrolled 1,968 participants across 42 U.S. clinical sites; 1,556 were assigned to the validation cohort, of whom 1,285 completed the initial visit. At the 6-month follow-up visit, 17 participants were lost to follow-up and were excluded from analysis. Only participants with valid results from the HelioLiver Dx test, ultrasound, and multiphasic MRI were considered evaluable. A total of 1,268 participants (81.5%) were evaluable, including 46 participants with HCC and 1,222 participants without HCC. Every performance figure in this series is calculated on that evaluable population. Published in the Journal of Hepatology, 2026. ClinicalTrials.gov identifier NCT03694600.
Have a case to contribute?
Clinicians using the HelioLiver test can submit de-identified cases for consideration in this series.