الفهرس 
Anatomy of the LiverOnly 14 pages are availabe for public view
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Abstract
Background: Hepatocellular carcinoma accounts for 70 - 85% of the worldwide total liver cancer burden. Diffusion-weighted imaging, a functional non-invasive diagnostic MRI technique, detects MR signal changes in hepatocellular carcinoma after trans-arterial chemo-embolization; tumor necrosis is associated with an increase in ADC value, thereby allowing differentiation between viable and necrotic portions of tumour.
The aim of this study is to elucidate the efficiency of diffusion weighted MRI technique in the detection of residual/ recurrent disease after transarterial chemoembolization ablation of non resectable HCC lesions. Patients and Methods: 33 patients with total 49 HCCs who underwent TACE, Pre-contrast T1, T2, STIR, diffusion-weighted (b factor 0, 200 and 800 s/mm2) and dynamic contrast enhanced MR images were obtained.
Results: We performed a cross-sectional study over 33 patients with total 49 TACE -treated HCCs and compared DWI results with those of Dynamic contrast enhanced MRI. Diffusion weighted MRI had a sensitivity of 86.7%, a specificity of 84.7%, a positive predictive value of 81.2%, a negative predictive value of 89.2% and overall agreement of 85.5%. The difference between the malignant and negative groups’ ADC variables was statistically significant (P value 0.001). The ROC curve showed that ADC values could predict residual/recurrence of tumor after treatment at a cut off level ≤1000.5 with 72.1% and 75.4% sensitivity and specificity respectively.
Conclusion: DWI & ADC value may serve as an alternative marker in further evaluation of HCC patients after TACE in patients having contraindications to contrast administration and in assessing small lesions adjacent/closely related to vessels where intravenous contrast administration is not most effective.