Evaluation of hepatocellular carcinoma after treatment with transcatheter arterial chemoembolization: comparison of Lipiodol-CT, power Doppler sonography, and dynamic MRI

Abstract

Of the three modalities, dynamic MRI was the best for evaluating the efficacy of TACE in the treatment of HCC. We also found that superficial lesions of the right lobe are good candidates for PD sonography. However, high signals on precontrast MR images, motion artifacts, and ultrasonic attenuation remain key limitations.

Added value of diffusion‐weighted imaging in the MRI assessment of perilesional tumor recurrence after chemoembolization of hepatocellular carcinomas

“…However, due to partial volume or beam-hardening artifact, the high attenuation density of the iodized oil can limit the accuracy of CT in depicting a small viable tumor portion in or adjacent to the lesion (4 -6). To avoid the interference of accumulated iodized oil, Doppler ultrasonography or dynamic MRI has been used as an alternative to dynamic CT (7)(8)(9)(10)(11); however, inherent ultrasonic attenuation or T1-weighted hyperintensity of hemorrhagic-necrotic changes still affects the correct interpretation of contrast-enhanced viable tumor tissue.…”

Role of diffusion-weighted imaging in evaluating therapeutic efficacy after transcatheter arterial chemoembolization for hepatocellular carcinoma

“…Median ADC before and after TACE is significantly increased among patients with HCC (8,9). Iodized-oil CT is widely used to confirm HCC response to TACE immediately after TACE (14)(15)(16). However, to the best of our knowledge, ADC has not been correlated to the degree of effectiveness of TACE against HCC as estimated by iodized-oil CT.…”

Gadoxetic acid‐enhanced MRI versus multiphase multidetector row computed tomography for evaluating the viable tumor of hepatocellular carcinomas treated with image‐guided tumor therapy

“…A variety of imaging techniques have been introduced for the evaluation of therapeutic efficacy after performing TACE and RFA for HCC (2)(3)(4)(5). Several investigators suggested that dynamic MRI using 1.5T Figure 2.…”

“…In addition to the foregoing features, an area with moderate hyperintensity on T2-weighted MR images and hypointensity on gadoxetic acid-enhanced hepatobiliary phase MR image compared with surrounding liver parenchyma was considered a viable tumor based on previous reports (3,5,6,13). The criteria for viable tumors on CT and gadoxetic acid-enhanced MRI after TACE were similar to those for viable tumors after RFA, and these criteria were based on previous reports (2,4,6,(16)(17)(18).…”

“…Although several therapeutic options have been proposed, the most widely used image-guided tumor therapies are TACE, RFA, or a combination of these two. After image-guided tumor therapy of HCCs, CT and MRI perform a crucial role in assessing the therapeutic efficacy and monitoring local tumor progression in the treated HCCs during follow-up and early detection of a viable tumor including residual tumor (i.e., incompletely treated tumor on immediate or 1-month followup CT after locoregional therapy) or local tumor progression (i.e., any growing or enhancing tumor in the treated lesion, where there had been no evidence of a residual tumor after locoregional therapy) can facilitate successful retreatment at an early stage (2)(3)(4)(5).…”