Hepatocellular carcinoma is the fifth commonest form of malignancy with 750,000 new patients diagnosed worldwide each year and is the 2nd major cause of cancer deaths worldwide. Screening of high risk patients, particularly those with cirrhosis, is well accepted clinically but is often suboptimal. This research theme aims to improve the methodology for performing clinical HCC surveillance. By creating validated and standardised interpretation of the variations in individual patients results we aim improve early HCC detection through accurate and easy to use screening tools.