Diffusion weighted magnetic resonance imaging in assessment of hepatocellular carcinoma after chemoembolization

Objective: To evaluate role of DWI in assessment of H.C.C. after TACE. Patients and methods: Twenty patients with H.C.C., mainly in sixth and seventh decades underwent TACE therapy. The baseline hepatic MRI before chemoembolization used 1.5-T closed magnet and then follow-up 3 weeks post-TACE included axial T1, T2 WI, DWI and dynamic contrast study. DWI used b values 0, 300, and 600 s/mm(2) then measured ADC value on dedicated workstation. Results: ADC measurement within H.C.C. tumor was significantly lower than normal liver parenchyma before TACE with increased ADC in the necrotic tissue after TACE. Fifteen patients showed a partial response with increased tumor necrosis. Complete response occurred in five patients as absent residual viable tumor tissue on DWI. Statistical analysis showed that DWI has sensitivity of 86.67%, specificity of 80%, positive predictive value of 92.86% and negative predictive value of 66.67%. Conclusions: MRI DWI offers quick and non-invasive technique to distinct between viable and necrotic tumor areas and helps the diagnosis of residual tumor. Potential effect of treatment can be detected as increase in the diffusion coefficient. We recommend that optimal follow-up after image guided trans-catheter tumor therapy should include DWI and contrast-enhanced MRI. (C) 2015 The Authors. The Egyptian Society of Radiology and Nuclear Medicine. Production and hosting by Elsevier B.V.