MRI OF HEPATOCELLULAR-CARCINOMA BEFORE AND AFTER TRANSCATHETER CHEMOEMBOLIZATION

Objective: Magnetic resonance imaging of hepatocellular carcinomas (HC Cs) was performed before and after transcatheter arterial chemoemboliz ation (TACE). The changes of tumor signal intensity were compared to r esidual tumor or tumor recurrence in the follow-up period. Materials a nd Methods: Fifteen cirrhotic patients with HCC were studied. All pati ents were examined with MRI both before and 3 months after TACE. Requi rement for the study was that all lesions were detectable by MR before TACE. Results: Magnetic resonance imaging detected 31 tumors. The cha nges of tumor signal intensity were compared to residual tumor or tumo r recurrence in the follow-up period. On T1-weighted (T1W) images befo re TACE, 16 tumors were hyperintense, 11 were isointense, and 4 were h ypointense; on T2W images, 26 tumors were hyperintense, 5 were isointe nse, and none were hypointense. On T1W images 3 months after TACE, 8 t umors were hyperintense, 18 were isointense, and 9 were hypointense; o n T2W images, 11 were hyperintense, 11 were isointense, and 9 were hyp ointense. All the tumors that became hypointense on T2W images after T ACE did not recur on follow-up. All lesions that were still hyperinten se on T2W images after TACE showed residual tumor during the follow-up . Among 11 tumors that were isointense on T2W images after TACE, 7 wer e hyperintense on T2W images before TACE; 6 of these did not recur. Fo ur tumors were isointense on T2W images before and after TACE; 2 of th ese showed residual tumor in the follow-up. On T2W images after TACE, 15 of 16 HCCs that decreased in signal intensity did not recur on foll ow-up. On T1W images no correlation was seen between the changes of th e signal intensity of the lesion and tumor recurrence in the follow-up ; however, 9 of 17 HCCs that did not recur after TACE showed decreased signal intensity. All the tumors (10 of 10) with decreased signal int ensity on both T1W and T2W images after TACE did not show tumor recurr ence on follow-up. Conclusion: The results suggest that MRI is useful in the assessment of the therapeutic effect of TACE in HCC.