ROLE OF DYNAMIC CONTRAST-ENHANCED AND DIFFUSIONWEIGHTED MRI IN EVALUATION OF RESPONSE OF HEPATOCELLULAR CARCINOMA AFTER CHEMOEMBOLIZATION.

Document Type : Original Article

Authors

1 Department of Radio-diagnosis, Faculty of Medicine, Ain Shams University, Cairo, Egypt.

2 Department of Radio-diagnosis, Medical Military Academy, Cairo, Egypt.

Abstract

Background: Hepatocellular carcinoma (HCC) accounted as the sixth most prevalent cancer worldwide and the third most common cancer leading to death. However unfortunately only a minority HCC patients are surgical candidates at the time of diagnosis, Transcatheter arterial chemoembolization (TACE) is one of the most commonly used intra-arterial therapies to treat unresectable HCC, Assessing early response to therapy using objective criteria is paramount for clinical care. Aim of the Work: To emphasize the role of dynamic contrast-enhanced and diffusion-weighted MRI in the assessment of response to treatment of hepatocellular carcinoma after transcatheter arterial chemoembolization (TACE). Patients and Methods Thirty-eight patients who were proven as HCC patients radiologically with AFP correlationwere enrolled in this study, fulfilled the inclusion criteria. They scheduled to undergo dynamic MRI with DWI within 90 days after one or more treatments of TACE. In case of absent evidence of residual, follow up was done within 90 days after the first MRI.
Results no statistically significant difference between group according to demographic data , and lesion size , while there is statistically significant relation between groups according to signal intensity (P < 0.001), dynamic enhancement
(P < 0.001 ), DWIs (P = 0. 036) and ADC value (P < 0.001). Conclusions dynamic MRI is still superior than Diffusion-weighted MR imaging with high specificity and remain the standard follow up technique in well cooperative patient yet DWI adding more to the overall sensitivity when combined with it and may help in condition of difficulty breath holding.

Keywords

Ain Shams Medical Journal
Volume 70, 10, 11 & 12
Issue 10, 11 & 12 (October, November & December)
July 2019
Pages 759-769

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