Value of Dynamic Subtraction MRI in Assessing HCC Response to Image-guided loco-regional Therapy | ||||
| African Journal of Gastroenterology and Hepatology | ||||
| Volume 6, Issue 1, 2023, Page 83-105 PDF (1.26 MB) | ||||
| Document Type: Original Clinical | ||||
| DOI: 10.21608/ajgh.2023.216003.1033 | ||||
 View on SCiNiTO | ||||
| Authors | ||||
Rasha Abdelhafiz Aly  1; Dina Hamdy Hashem1; Rania A.M. Abouyoussef2; Heba Said Ellaban1
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| 1Radiology Department, National Liver Institute, Menoufia University | ||||
| 2Tropical Medicine Department, Alexandria University | ||||
| Abstract | ||||
| Background: Hepatocellular carcinoma (HCC) is considered one of the foremost cancers worldwide. Although the hepatic resection of HCC has a high existence in the clinical scenarios, locoregional management is preferred owing to the preservation of hepatic parenchyma with lower morbidity and mortality. Dynamic contrast-enhanced MR with subtraction imaging improves the evaluation of managed HCC with easy detection of residual or recurrent viable lesions. Patients and methods: This study was designed in a retrospective pattern from December 2020 to December 2022. Forty patients were referred to our radiology department with solitary HCC, underwent therapeutic intervention, then underwent follow-up by dynamic MRI study. Results: Forty patients with solitary HCC were conducted during our study; all underwent locoregional therapy with follow-up by dynamic MRI with subtraction technique one month later. The subtraction image has a sensitivity of 100%, specificity of 100%, PPV of 100%, NPV of 100%, and 100% accuracy, compared to 90.91%, 77.78%, 83.33%, 87.5%, and 85% for conventional dynamic images, 45.45%, 100%, 100%, 60% and 70% for diffusion-weighted images. Analysis of those results exhibited a considerable additive value of the subtraction technique to the dynamic MRI to detect the response of HCC after management. Conclusions: Subtraction MRI is a pivotal tool to assess the interventional treatment of HCC, particularly in lesions having pre-contrast high signal intensity with distinguished radiologists’ confidence. | ||||
| Keywords | ||||
| Dynamic MRI; Hepatocellular carcinoma; Locoregional therapy; Subtraction MRI; DWI; HCC response; T1 signal; HCC management; sensitivity; specificity | ||||
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