Does the Diffusion Weighted Images and Subtraction MRI of Hepatocellular Carcinoma has a Role in Predicting Outcome of Transarterial Chemoembolization?

Abstract

epatocellular 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 TACE procedure is an important task in oncologic imaging. Early favourable 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. (DWI) provides unique information about tumor cellularity and cell membrane integrity. Therefore, DWI is sensitive to microenvironment changes that occur in the tumor post treatment. This can be evaluated quantitatively for the calculation of the apparent diffusion coefficient (ADC). In particular, the degree of tumor necrosis of large HCC following TACE may be predicted by DWI. Therefore, DWI not only avoids radiation exposure of CT examination and the risk of contrast material-induced nephropathy, it also may be a short-term follow-up tool for post TACE HCCs’ guiding further patient management.