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© The Author(s) 2019. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.

Abstract

Background

Hepatocellular carcinoma is considered to be the fifth most common cancer worldwide. Resection and liver transplantation have a high survival in the correct clinical scenarios; however, locoregional therapy has many advantages over tumor resection like preservation of hepatic parenchyma and overall less morbidity and mortality. Our aim was to present the role of dynamic subtraction MRI technique in the assessment of treatment response of hepatocellular carcinoma to transarterial chemoembolization.

Methods

The study consisted of 43 patients with 55 hepatocellular carcinoma lesions who underwent transarterial chemoembolization procedure and followed up by 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 was preformed 2–4 months later. Five patients were excluded due to misregistration artifact at the subtraction images. The final cohort is 38 patients having 50 lesions. Precontrast T1, T2, dynamic contrast enhanced, and diffusion-weighted images were acquired. Subtracted dynamic images were created on the workstation. Sequences were assessed by three experienced readers in hepatic imaging. The sensitivity, specificity, positive predictive value, negative predictive value, 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.

Conclusion

Subtraction technique is a useful confirmative tool as it had higher sensitivity, specificity, PPV, and NPV values compared to the dynamic and diffusion images with high level of agreement between the readers and also associated with significantly higher reader confidence levels.

Details

Title
The value of dynamic subtraction MRI technique in the assessment of treatment response of hepatocellular carcinoma to transcatheter arterial chemoembolization
Author
Metwally, Lamiaa I. A. 1 ; Mahmoud, Bahaa Eldin 2   VIAFID ORCID Logo  ; Yehia, Mahmoud 3 

 Cairo University, Radiology Department, Faculty of medicine, Cairo, Egypt (GRID:grid.7776.1) (ISNI:0000 0004 0639 9286) 
 Cairo University, Radiology Department, Faculty of medicine, Cairo, Egypt (GRID:grid.7776.1) (ISNI:0000 0004 0639 9286); Giza, Egypt (GRID:grid.7776.1) 
 Cairo university student hospital, Cairo, Egypt (GRID:grid.7776.1) (ISNI:0000 0004 0639 9286) 
Pages
20
Publication year
2019
Publication date
Dec 2019
Publisher
Springer Nature B.V.
ISSN
0378603X
e-ISSN
20904762
Source type
Scholarly Journal
Language of publication
English
ProQuest document ID
2812337922
Copyright
© The Author(s) 2019. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.