Recognition of the role of Dynamic MRI in the diagnosis of residual or recurrentHCC afterradiofrequency ablationby the additionof subtraction sequence.
· Hepatocellular carcinoma (HCC) is one of the most common cancers worldwide.
It has a poor prognosis unless treated.
· Many ablative treatment options are currently of wide use as surgical,
thermal or functional .
· Among all the thermal ablative technique; RFA is the one most widely used for both primary and secondary malignances of the liver.
· Contrast enhanced dynamic CT and MRI are widely used in the post-treatment follow-up of these patents,
· RFA produces coagulation necrosis; sometimes demonstrate imaging features...
Findings and procedure details
· Cases should be subjected to full clinical assessment,
laboratory investigations with the revision of their previous radiological investigations.
· Suggested protocol that could be used: Axial T1,
T2 SPAIR sequences and dynamic imaging using 3D fat-suppressed T1-weighted gradient echo sequence.
The dynamic study is performed after contrast injection consisting of one pre-contrast series followed by at least four successive post-contrast series.
· Subtraction imaging is performed by subtracting the pre-contrast series from the late arterial phase or any phase of choice.
DynamicMRI is valuable in detecting recurrent lesions however,
this value is augmented by the addition of subtraction technique especially in lesions having high T1 signal.
and Erden A.
Post-treatment MRI findings of hepatocellular carcinoma. Diagn Interv Radiol 2009: 15:111-120.
Thermoablative Treatment for Malihnant Liver Lesions: 10-Year Experience of MRI Appearance of treatment Response.
Kamel IR and Morgan HR.
MRI appearance of treated liver lesions.
Subtraction Imaging Applications...