Online ISSN: 2515-8260

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

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Ashgan Moustafa AbdelSabour #1 , Shrouk Mohamed Awadallah 2 , Noha Mohamed Osman 2 & Hesham Mahmoud Manso

Abstract

Background: Hepatocellular carcinoma represents 70 - 85% of the global liver cancer burden. Dif usion-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 dif usion 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. Dif usion 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%. Dif erentiation among malignant and negative groups’ ADC variables were significantly dif erent. 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.

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