Abstract
BackgroundThe transcatheter arterial chemoembolization (TACE) is one of the treatment lines for patients with hepatocellular carcinoma (HCC), this study was conducted to assess the role of functional imaging including the DWI, ADC and 18F-2-fluoro-2-deoxyglucose (FDG) positron emission tomography-computed tomography (PET/CT) for detection of residual HCC after TACE as compared to the structural liver imaging reporting and data system (LI-RADS).ResultsThe optimal cut off value of standardized uptake value ratio (SUVmax/liver SUVmean ratio) for detection of residual viable HCC after TACE was 1.09 with 88.9%, 87.5% and 88.6% sensitivity, specificity, and accuracy respectively, a lower diagnostic value was noted in the qualitative visual FDG PET/CT assessment with sensitivity, specificity, and accuracy of 81.5%, 75% and 80% respectively. The sensitivity, specificity, and accuracy of DWI for identification of post-TACE viable HCC were 77.8%, 75%, and 77.1% respectively. The optimal cut off value of ADC for the diagnosis of variable HCC was 1.32 × 10−3 mm2/s with sensitivity, specificity, and accuracy of 81.5%, 75%, and 80% respectively.ConclusionsDWI, ADC and FDG PET/CT are effective functional imaging modalities for the evaluation of viable residual HCC post-TACE with comparable findings for the dynamic cross-section imaging.
Highlights
The transcatheter arterial chemoembolization (TACE) is one of the treatment lines for patients with hepatocellular carcinoma (HCC), this study was conducted to assess the role of functional imaging including the Diffusion-weighted image (DWI), apparent diffusion coefficient (ADC) and 18F-2-fluoro-2-deoxyglucose (FDG) positron emission tomography-computed tomography (PET/CT) for detection of residual HCC after TACE as compared to the structural liver imaging reporting and data system (LI-RADS)
The aim of this study was to emphasize the role of functional imaging of the DWI, ADC and the FDG PET/ CT in early detection of post-TACE residual/recent HCC compared to the liver imaging reporting and data system (LI-RADS)
HCC patients who were treated with iodized oil, with the three-month post-treatment DWI, ADC, FDG PET/ CT, triphasic contrast-enhanced computerized tomography (CECT) and Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) imaging surveillance were interpreted according to the LI-RADS v2018 treatment response design were included in our research
Summary
The transcatheter arterial chemoembolization (TACE) is one of the treatment lines for patients with hepatocellular carcinoma (HCC), this study was conducted to assess the role of functional imaging including the DWI, ADC and 18F-2-fluoro-2-deoxyglucose (FDG) positron emission tomography-computed tomography (PET/CT) for detection of residual HCC after TACE as compared to the structural liver imaging reporting and data system (LI-RADS). Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) is a well-established modality in the imaging of liver and hepatic focal lesions, MRI signal wasnt degraded by lipiodol droplets; the newly formed/residual lesions are best identified by the DCE-MRI [3, 8]. The liver imaging reporting and data system (LI-RADS) has released an algorism for evaluating the treatment response of HCC after locoregional therapy which depend mainly upon the enhancement features in the dynamic contrast enhancement study [9]
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