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Abstract Hepatocellular carcinoma is the sixth most common cancer throughout the world. In the intermediary stages, which make up approximately one third of the patients at the time of diagnosis, the recommended treatment is chemoembolization. Chemoembolization is based on the principle of intra-arterial injection of an antineoplastic agent, followed by occlusion of the artery or arteries, which supplies the tumor(s). In order for the treatment to be effective, it is essential that it is injected into the artery or arteries, which supply the tumor(s). These arteries must be identified by imaging in the pre-treatment assessment. Modification of the RECIST criteria in recent guidelines in which evaluation of the treatment response should take into account the induction of intra-tumoral necrotic areas in estimating the decrease in tumor load, and not just a reduction in tumor size. Thus the diameter of the target lesions with viable tumor should guide all measurements The aim of this study was to investigate the ability multi-detector computed tomography (MDCT) and magnetic resonance imaging (MRI) to evaluate Tumor Response after Interventional Management for the Treatment of Hepatocellular Carcinoma This retrospective study was conducted on 20 patients with Hepatocellular Carcinoma referred to the Radio diagnosis department of Alexandria University Hospitals for imaging evaluation in the period from May 2017 to the May 2018. The studied patients with Hepatocellular Carcinoma were having an age range from 50 – 70 years with Mean (62.) they were 19 males and 1 female. (65%) had pervious TACE, (20%) had no previous operation (10%). TACE procedure was done to (40%), RFA procedure was done in (15%) and combined TACE and RFA was done to (45%). The current study reported 17 out of the patients 20 patients (85%) had no enhancement in CT post-operative on the other hand 12 patients (60%) had residual active enhancing tissue in MRI Among of three patients had incomplete lipiodol filling on non-contrast CT. Two of these patients had a partial response and one patient had stable disease on triphasic CT post-operatively. Whereas on MRI, two patients had a partial response and one patient had progressive disease. The results in this study revealed that MRI is superior in detecting residual activity within the hepatic tumor compering to CT after transarterial chemoembolization. And The lipiodol filling has major impact on CT and MRI mRECIST where 17 patients were diagnosed as complete response on CT turnout to be only 14 on MRI |