Role of dynamic contrast-enhanced and diffusion weighted MRI in evaluation of response of Hepatocellular Carcinoma after chemoembolization

Abstract

Transcatheter arterial chemoembolization is used to provide therapeutic options for non-resectable patients in order to improve survival and quality of life in a palliative setting, as well as downstaging or bridging and thus making patients amenable for potentially curative surgical treatment. So, on the close, follow-up imaging studies after TACE, the detection of a residual or locally recurrent tumor is mandatory to introduce the correct management as early as possible to avoid complications or the advancement of the disease. The dependence on the morphological criteria of (RECIST) is confusing and defective for monitoring the response to therapy, as such treatment usually leads to early tumor volume increase due to tumor necrosis. MRI is a multiparametric modality providing anatomic, functional and molecular parameters to assess the response to treatment. Non-contrast T1- and T2-weighted images detect the changes in the morphology as well as the fluid content and fibrosis.