الفهرس 
Anatomy of the LiverOnly 14 pages are availabe for public view
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Abstract
Background: Trans-arterial chemoembolization (TACE) is widely used as an interventional procedure in treatment of hepatocellular carcinomas (HCCs). Apparent diffusion coefficient (ADC) value can be used in evaluating its efficacy in order to rule out or in residual tumor tissue.
Aim of the work: To assess the role of Diffusion weighted images (DWI) and ADC value in evaluating HCCs post TACE
Patients and methods: a retrospective analytical study on 25 patients with HCC; to assess therapeutic response of HCC cases after TACE by ADC mapping MRI technique in comparison to dynamic contrast enhanced study (DCE-MRI), to evaluate its accuracy, sensitivity and specificity in detecting treatment response and or residual tumor.
Results: Comparative study between the 2 groups revealed; highly significant increase in ADC value, in active group; compared to inactive group; with highly significant statistical difference (p < 0.01).Comparative study between DCE-MRI and DWI/ADC assessments revealed; non-significant difference in sensitivity, specificity, PPV and NPV in HCC patients; with non-significant difference (p > 0.05).Spearman’s correlation analysis shows that; AFP level had a highly significant negative correlation with ADC value; with highly significant statistical difference (p < 0.01). By using ROC-curve analysis, DWI/ADC value at a cutoff point (≤1.33) detected patients with residual active lesions, with good accuracy(84%), sensitivity84% and specificity 83% (p = 0.0001).
Conclusion: Finally we conclude that, DCE-MRI is a powerful tool in detection of tumor viability and complications after TACE yet Imaging protocol should include DWI/ADC images with ADC mapping and value for better tissue characterization.