Online ISSN: 2515-8260

Author : Awadallah, Shrouk Mohamed


THE ROLE of DIFFUSION WEIGHTED IMAGING in THE EVALUATION of TREATMENT RESPONSE OF HEPATOCELLULAR CARCINOMA AFTER TRANS-ARTERIAL CHEMOEMBOLIZATION

Ashgan Moustafa AbdelSabour; Shrouk Mohamed Awadallah; Noha Mohamed Osman; Hesham Mahmoud Mansour

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 9, Pages 343-355

Background: Hepatocellular carcinoma represents 70 - 85% of the global liver cancer burden.
Diffusion-weighted imaging, a non-invasive diagnostic MRI technique, detects MR signal changes
in hepatocellular carcinoma after trans-arterial chemo-embolization; tumor necrosis accompany
by increasing in ADC values, as such allowing distinction among viable and necrotic tumors
portion. An investigation objective was to elucidate diffusion weighted MRI technique efficiency in
residual/ recurrent diseases detection after transarterial chemoembolization of non operable HCC
lesions.
Results: We performed a cross sectional study over 33 patients with total 49 TACE -treated HCCs
and compared DWI results with those of Dynamic contrast enhanced MRI. Diffusion weighted
MRI has sensitivity of 86.7%, specificity of 84.7%, positive predictive of 81.2%, negative predictive
of 89.2% and agreement of 85.5%. Differentiation among malignant and negative groups’ ADC
variables were significantly different. ROC curve shows, ADC values could predict
residual/recurrence of tumor after treatment at a cut off level ≤1000.5 with 72.1% and 75.4%
sensitivity and specificity, respectively.
Conclusion: DWI & ADC values may aid as alternative markers in assessment of HCC cases after
TACE in patients having contraindications to contrast administration and in assessing small
lesions adjacent/closely related to vessels where intravenous contrast administration is not most
effective.