Response Assessment Following Image-Guided Therapy of Hepatocellular Carcinoma

Abstract

<jats:title>Abstract</jats:title><jats:p>Image-guided locoregional therapies have an important role in the management of patients with hepatocellular carcinoma (HCC). Recent advances in the ablative as well as endovascular therapies have expanded the role of interventional radiologists in the treatment of HCC. Following image-guided therapy, an accurate response assessment is vital. Knowledge regarding normal postprocedure changes and subtle signs of residual or recurrent disease is important. In this review, we discuss various response evaluation criteria currently employed for HCC. We also discuss the postprocedure imaging features suggestive of residual disease or recurrence and imaging biomarkers for response assessment.</jats:p>

Indian College of Radiology and Imaging Guidelines on Interventions in Hepatocellular Carcinoma

“…First follow-up scan should be performed at 1 month after ablation. 108 Thereafter, follow-up imaging should be performed every 3 months for the first year. After the first year, surveillance is performed every 6 months.…”

Indian Society of Vascular and Interventional Radiology Expert Consensus Statements for Ablation in Hepatocellular Carcinoma: Part II

“…LTP is the appearance of tumor foci at the edge or within the ablation zone, after adequate ablation and an absence of viable tissue has been documented using imaging criteria at baseline follow up. 46,47 For equivocal lesions, dynamic contrast-enhanced MRI with diffusion-weighted imaging (DWI) and apparent diffusion coefficient (ADC) mapping act as useful adjunctive techniques and allow differentiation between tumor and post-treatment changes. 48 Low ADC value in the area of hyperintense signal on T2-weighted image is suggestive of viable tumor.…”