Background: Evaluation of hepatic malignancies response after loco-regional treatment is crucial to assess treatment success and to guide future therapy. MRI DWI liver added to conventional unenhanced and contrast enhanced MRI always be used in the follow up of RFA showing promising results in the detection of ablation site recurrence/residual lesions.
Objective: Evaluation of the role of dynamic and diffusion MRI in evaluation of recurrent/residual hepatic neoplasms after radiofrequency ablation.
Patients and methods: This prospective study included 50 patients, 40 males and 10 females. Patients ages ranged between 45 and 80 years with the mean age of 57.02 years, (SD±8.07). Patients were referred from Tropical Medicine Department to MRI unit after the procedure of radiofrequency ablation of complete ablated malignant liver tumors.
Results: Thirty seven patients (74%) had resolved lesions, while 13 patients (26%) had recurrent/residual lesions. The border of resolved lesions were smooth, but in unresolved lesions were nodular in 11 patient out of 13 (84.6%), and irregular in two patients (15.4%). The measured cut off value between the completely ablated lesions and residual/recurrent lesions was 1.05x10-3 mm2/s. The ablation zones can be differentiated from liver parenchyma visually in the DWIs and by means of ADC in all patients. There were no statistical differences in the mean ADC values between the ablation zones of the resolved and unresolved lesions.
Conclusion: Dynamic and DWI showed viable tumor regions, and suspected areas in the periphery of the ablation zone could be identified more easily, and analyzed precisely in conjunction with the conventional T1 and T2 WIs.