Evaluating the therapeutic effect of hepatocellular carcinoma treated with transcatheter arterial chemoembolization by magnetic resonance perfusion imaging

Abstract

To compare the characteristics of magnetic resonance perfusion-weighted imaging (MRPWI) scans before and after transcatheter arterial chemoembolization (TACE) treatment of hepatocellular carcinoma (HCC) and to apply MRPWI in evaluating the therapeutic effect of TACE and prognosis of HCC. Thirty-five patients with HCC undergoing their first TACE treatment were enrolled in this study. T2WI, T1WI, and PWI of MRI were performed 24-48 h before TACE and 48-168 h after TACE. Perfusion parameters calculated with the maximum slope were used to create a time-signal intensity curve (TSC). The efficacy of TACE treatment in HCC was evaluated by examining the hemodynamic changes in TSC caused by TACE treatment. TSC before TACE showed a pattern of a quick decrease and a slow increase in the tumor region of interest in 34 patients with HCC, whereas the TSC for normal liver tissues showed a pattern of slow decrease and slow increase. After TACE, the fluctuating range of TSC was significantly reduced in 31 patients, slightly reduced in three, and did not change significantly in one. The 3-year survival rate was 28.6%. MRPWI of the liver does not only show the anatomy of HCC lesions but also reflects hemodynamic changes of HCC before and after TACE to a certain extent. It is very useful for clinical evaluation of the efficacy of TACE for HCC.