الفهرس 
The value of dynamic subtraction mri technique in the assessment of treatment response of hepatocellular carcinoma to transcatheter arterial chemoembolization
ABSTRACTOnly 14 pages are availabe for public view
 |  | from | 146 |  |  |
| | | from | 146 | | |
Abstract
Background: HCC is considered to be the 5th most common cancer worldwide. TACE may be appropriate in patients who are not surgical candidates. MRI allows the detection of anatomic, functional and molecular parameters in order to assess the response to treatment. Unfortunately, lesions treated with TACE typically undergo coagulative hemorrhagic necrosis that may appear hyper intense on unenhanced T1WI, making contrast-enhanced evaluation difficult. The aim of this study is to present the role of dynamic subtraction MRI technique in the assessment and follow up of the response of HCC to the TACE procedure. Methods: 38 patients having 50 HCC lesions that underwent TACE procedure has been followed up dynamic MRI of the liver with post processing to obtain subtraction images 1-1.5 months after the procedure. If no signs of disease activity, another follow up study preformed 3 months later. Precontrast T1, in and out of phase, T2, heavy T2, Dynamic contrast enhanced and diffusion weighted images (b factor 0, 400, 800mm2/s) sequences were taken. Subtracted dynamic images were created on the Philips MR work sation. Sequences were assessed by three experienced readers in hepatic imaging. The sensitivity, specificity, PPV, NPV, 95% confidence interval and overall agreement were calculated for the dynamic, and subtracted dynamic images. Results: the subtraction images have sensitivity of 96%, specificity of 100%, PPV of 100% and NPV of 100% Compared to 96%, 100%, 100%, 96% and 96%, 100%, 100% 96% for the three readers respectively. On the other hand, the dynamic images has sensitivity of 92%, specificity of 96%, PPV of 95% and NPV of 92.3% compared to 92%, 96%, 95%, 92.3% and 80%, 68%, 71.4% and 77.2% for the three readers respectively