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Editorial: ultrasound surveillance of hepatocellular carcinoma in the 21st century – authors' reply

modalities compared to ultrasound in most societies. Neither modality is without risk. CT involves significant radiation doses and both CT andMRI require the administration of intravenous contrast for optimum examination which can be associated with significant side effects. Despite its limitations, ultrasound will remain the primary imaging modality for HCC for the foreseeable future. It is therefore crucial to maximise the performance of ultrasound as a screening tool by ensuring it is performed and reported by adequately trained operators; they need to be experienced in hepatobiliary imaging in order to obtain high-quality diagnostic examinations and to minimise the referral rate for CT/MRI imaging surveillance, and the ensuing financial and resource implications associated with this.