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The Role of Diffusion Weighted Magnetic Resonance Imaging and Subtraction Magnetic Resonance imaging in Assessing Treatment Response of Hepatocellular Carcinoma After Transarteri

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Last updated: 24 Dec 2024

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Abstract

Background: Hepatocellular carcinoma (HCC) is one of the most common cancers worldwide, and has a poor prognosis unless treated. Ablative therapies are promising treatment options for patients who are not eligible for surgery. Monitoring tumor response after transarterial chemoemolization (TACE) procedure is an important task in oncologic imaging. Early favorable response indicates effectiveness of therapy, while early treatment failure identification is also critical in patient management. In such cases further re-treatment will be mandatory. Aim of work: The aim of this study is to evaluate the efficiency of both diffusion weighted images and subtracted dynamic MRI technique in the detection of residual/ recurrent disease after TACE ablation of non resectable hepatocellular








carcinoma (HCC) lesions. Accurate judgment of tumor viability will help diagnose the need for further treatment sessions. Patients and Methods: This study included 32 patients having 54 HCC lesions that underwent transarterial chemoembolization procedure over a period of 6 months (2017- 2018) were followed up 1-1.5 months by dynamic MRI. 12 patients of which underwent a second follow up within 3-4 months. Patients' ages ranged between 59 to 73 years (mean age 53.1); 26 patients were males and 6 were females. All patients had liver cirrhosis related to chronic viral hepatitis. Results: In 1ry response and follow up findings post TACE, where good response was defied as disappearance of any intra tumoral arterial enhancement in treated lesions, residual disease was defined as at least 30% reduction in the sum of diameters of the viable enhancing lesion in the arterial phase, no response was less than 30% reduction in the enhancing lesion diameters. Progressive disease was defined as 20% increase in the sum of diameters of the enhancing lesions in comparison to the target lesion diameter at the start of treatment. Conclusion: MRI is a powerful tool in detection of residual tumor viability, quantifying tumor necrosis and detecting complications after TACE. Imaging protocol should include dynamic study combined with post processing subtraction images for better tissue characterization.

DOI

10.21608/ejhm.2018.9133

Keywords

DW MRI, subtraction MRI, Hepatocellular carcinoma, transarterial chemoembolization

Authors

First Name

Elhadi I.

Last Name

Ahmed

MiddleName

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Affiliation

Department of Radiology, Faculty of Medicine -Ain Shams University

Email

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City

-

Orcid

-

First Name

Mohammed S.

Last Name

Hassan

MiddleName

-

Affiliation

Department of Radiology, Faculty of Medicine -Ain Shams University

Email

-

City

-

Orcid

-

First Name

Mohammed G.

Last Name

Abdel-Mutaleb

MiddleName

-

Affiliation

Department of Radiology, Faculty of Medicine -Ain Shams University

Email

-

City

-

Orcid

-

Volume

72

Article Issue

3

Related Issue

1778

Issue Date

2018-07-01

Receive Date

2018-07-15

Publish Date

2018-07-01

Page Start

4,165

Page End

4,174

Print ISSN

1687-2002

Online ISSN

2090-7125

Article File

EJHM_Volume 72_Issue 3_Pages 4165-4174.pdf

PDF . 471.6kB

Link

https://ejhm.journals.ekb.eg/article_9133.html

Detail API

https://ejhm.journals.ekb.eg/service?article_code=9133

Order

21

Type

Original Article

Type Code

606

Publication Type

Journal

Publication Title

The Egyptian Journal of Hospital Medicine

Publication Link

https://ejhm.journals.ekb.eg/

MainTitle

The Role of Diffusion Weighted Magnetic Resonance Imaging and Subtraction Magnetic Resonance imaging in Assessing Treatment Response of Hepatocellular Carcinoma After Transarterial Chemoembolization

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Type

Article

Created At

22 Jan 2023