Spectrum of Imaging Findings by Dynamic MRI Post Hepatic Intervention by Loco-Regional Therapies for Hepatocellular Carcinoma

Abstract Background: Liver cirrhosis and Hepatocellular Carcinoma (HCC) constitute one of the major causes of morbidity, mortality, and high health care costs worldwide. Multiple treatment options are available for HCC depending on the clinical status of the patient, size and location of the tumor, and available techniques and expertise. Locoregional treatment options are multiple. The most challenging part is how to assess the treatment response by different imaging modalities, but our scope will be assessing the response to locoregional therapy for HCC by MRI. Aim of Study: To study the role of dynamic contrast enhanced MRI in follow-up of after treatment by different loco regional procedures and review the spectrum of imaging findings. Subject and Methods: This study was conducted on 45 patients with different age group 30 to 73 years with the mean age of 58 years having different site, size and shape of hepato-cellular carcinoma (proved mainly by combination of elevated alpha-fetoprotein, typically neoplastic enhancement by spiral CT or dynamic MRI and having hepatitis C or/& B viruses). Results: MRI was found to be of great value in the follow-up of cases of HCC that underwent locoregional therapy specially in diagnosing residual or recurrent tumor tissue in the embolized lesions and in detecting new developed lesions. This technique can be implemented simply and reliably. The study found that almost all of the embolized lesions in the unresolved group of patients (residual/recurrence) showed enhancing areas within in the arterial phase, the study also found that 68.9% of the embolized lesions in the resolved group of patients (complete tumor ablation) were not enhanced at all while 24.4% of them showed delayed marginal enhance-ment. Conclusion: MRI is a powerful tool in detection of tumor viability and complications after locoregional treatment of hepatocellular carcinoma.