AbstractBackground: Transarterial chemoembolization (TACE) is the recommended treatment for patients with intermediate-stage hepatocellular carcinoma (HCC) who have many tumors but no invasion of blood vessels. This stage is the most often diagnosed stage at the time of diagnosis. The objective of this study was to compare the efficacy of Triphasic multidetector computed tomography and dynamic magnetic resonance imaging (MRI) in assessing the response of HCC to TACE, specifically in terms of tumor necrosis and viable tumor tissue. The study also aimed to investigate the impact of Lipiodol on the evaluation of tumor necrosis in patients with HCC.
Methods: This prospective study was carried out on 60 patients aged 46 to 70 years old, both sexes, with HCC patients within one month after TACE. All patients were subjected to triphasic- CT and Dynamic MRI for follow up after TACE.
Results: Triphasic CT showed 54.5% sensitivity, 95% specificity, 94.5% positive predictive value (PPV) and 68.7% negative predictive value (NPV) (p<0.001). Dynamic MRI showed 82.6% sensitivity, 97.3% specificity, 96.3% PPV and 85.2% NPV (p<0.001). There was poor agreement between Triphasic CT and Dynamic MRI according to arterial phase (kappa=0.241, 95% CI=0.064-0.298), portal phase (kappa=0.217, 95% CI=0.082-0.187), and delayed phase (kappa=0.7099, 95% CI=0.064-0.298).
Conclusions: MRI is superior to Triphasic CT for the detection of viable tumor residuals after TACE. Compared with multiphasic CT and dynamic MRI has a higher sensitivity.
