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

Journal Title: The Egyptian Journal of Hospital Medicine - Year 2018, Vol 72, Issue 3

Abstract

<span>Background: </span><span>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. </span><span>Aim of work: </span><span>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 </span><br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <span>carcinoma (HCC) lesions. Accurate judgment of tumor viability will help diagnose the need for further treatment sessions. </span><span>Patients and Methods: </span><span>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-</span><span>4 months. Patients’ ages ranged </span><span>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. </span><span>Results: </span><span>In 1</span><span>ry </span><span>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. </span><span>Conclusion: </span><span>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. </span>

Authors and Affiliations

Eman Helal

Keywords

Related Articles

Assessment of Knowledge, Awareness, and Behavior of Folic Acid

<strong>Background:</strong> A balanced diet is very important for pregnant women, which consists of proteins, carbohydrates, vitamins, minerals and fats. Supplements do not replace a healthy diet but rather ensure that...

Serum Procalcitonin and C-reactive Protein Level as Markers of Bacterial Infection

<strong>Background: </strong>C-reactive protein (CRP) and procalcitonin (PCT) are useful diagnostic tools used to estimate the risk of bacterial infection and the severity of the infection. The accurate diagnosis of bact...

Role of CT in the Diagnosis and Follow up of Pediatric Oncology Patients with Fungal Infection

<strong>Background: </strong>invasive fungal infections are rare in pediatric population, but have a high morbidity and mortality rates despite the development of antifungal treatment. It ranges from superficial, mucosal...

Comparison of the Accuracy of Three Algorithms in Predicting Accessory Pathways among Adult Wolff-Parkinson-White (WPW) Syndrome Patients in our Population

<strong>Background: </strong>after the introduction of catheter ablation of atrioventricular accessory pathways (APs) in Wolff-Parkinson-White (WPW) syndrome, to facilitate planned ablation and minimize catheter-related...

Role of Surgery in Management of Discitis

<strong>Background:</strong> discitis is an inflammation of the vertebral disc space which may spontaneous or post spinal surgery; that is often diagnosed late. With good response to conservative treatment and in some co...

Download PDF file
  • EP ID EP584104
  • DOI 10.21608/ejhm.2018.9133
  • Views 105
  • Downloads 0

How To Cite

Eman Helal (2018). The Role of Diffusion Weighted Magnetic Resonance Imaging and Subtraction Magnetic Resonance imaging in Assessing Treatment Response of Hepatocellular Carcinoma After Transarterial Chemoembolization. The Egyptian Journal of Hospital Medicine, 72(3), 4165-4174. https://europub.co.uk/articles/-A-584104