Type:
Educational Exhibit
Keywords:
Neoplasia, Diagnostic procedure, MR, Abdomen
Authors:
M. M. A. Rezk1, H. Nafady1, G. Abdelrazek1, M. T. El-Diasty2, A. Nazeer1, W. Mohammed1, A. Sabry3; 1Cairo/EG, 2Jeddah/SA, 3Doha/QA
DOI:
10.26044/ecr2019/C-0267
Background
· 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,
chemical,
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 on follow-up studies that could be similar to residual or recurrence.
· There is suggestive evidence that MRI is more accurate than other radiological modalities in the detection of residual or recurrent tumours.
The European Association for the Study of Liver Disease (EASL) has recommended the use of lesion enhancement,
rather than changes in size,
as the standard method to determine treatment response.
· Subtraction imaging in the liver is a relative new technique (used always in breast and angiography) and increasingly used imaging technique in addition to conventional contrast enhanced MRI.
Subtraction in the follow-up after RFA and TACE shows successful results in the detection of ablation site recurrence.