Additive role of dynamic subtraction MRI in assessment of unresolved HCC post-radiofrequency ablation

Theodor Bilharz Research Institute

Bibliographic Information

Authors: El-Assaly H.; Abdallah M.F.H.; Mohamed W.M.; Youssef M.I.

Journal: Egyptian Journal of Radiology and Nuclear Medicine

Publisher: Springer Science and Business Media Deutschland GmbH

Publication Date: 12 October 2021

Volume / Issue: Volume 52 / Issue 1

Article No.: 257

ISSN: 0378603X

DOI: 10.1186/s43055-021-00636-5

Scopus: View on Scopus

Document Type: Article

Access: All Open Access; Gold Open Access; Green Open Access

Authors and Affiliations

El-Assaly H., Diagnostic and Interventional Radiology, Cairo University, Cairo, Egypt; Abdallah M.F.H., Diagnostic and Interventional Radiology, Theodor Bilharz Research Institute, Giza, Egypt; Mohamed W.M., Faculty of Medicine, New Giza University, Giza, Egypt; Youssef M.I., Faculty of Medicine, Benha, Egypt

Abstract

Background: Malignant Hepatocellular carcinoma (HCC) is one amongst the foremost widespread cancers within the world. Radiofrequency ablation (RFA) is that the most generally used substitute tool for hepatic carcinoma treatment. Monitoring tumoral response to loco-regional therapy is a vital mission in oncological imaging. Dynamic contrast enhanced MR and recently added subtraction imaging technique improve assessment of the ablated hepatic focal lesions. The aim of this study is that the evaluation of the role of Subtraction MRI within the detection of recurrent or residual tumoral viability after RF ablation. Results: Fifty patients were conducted during this retrospective study, all underwent RFA for 76 hepatic focal lesions and underwent Dynamic MRI study 1 month after ablation. Subtraction imaging was then performed. MRI images were interpreted by two readers who are experienced in hepatic imaging. The primary reader interpreted the standard Dynamic MRI and was blinded to the subtraction sequences; the second reader interpreted both Dynamic and Subtraction MRI images. the primary reader detected 49 resolved cases by dynamic MRI, while the second reader detected residual activity in 6 cases out of 49 via subtraction dynamic MRI (added value). The second reader agreed with first reader in 43 cases (agreement).The first reader detected 27 residual cases by dynamic MRI. The second reader disagreed with first reader in 11 cases appeared resolved out of 27 via subtraction dynamic MRI (added value). The second reader agreed with first reader in residual activity in 16 cases (agreement).The statistical analysis of those results revealed a big additive value of the subtraction imaging to the dynamic MRI (P < 0.001) with moderate degree of agreement between the 2 diagnostic tools (Kappa value = 0.491). This implies that Subtraction MRI significantly improves the reader confidence level within the assessment of treatment response following loco-regional therapies for HCC. Conclusion: Dynamic Subtraction MRI is a powerful detector for real enhancement in treated HCC lesions after radiofrequency ablation and hence increasing the degree of readers’ confidence and accuracy of treated lesions in follow-up studies. So it's recommended to feature this powerful tool as a routine to any or all Dynamic MRI studies of the Liver. © 2021, The Author(s).

Keywords

Dynamic MRI; HCC; Locoregional therapy; RFA; Subtraction dynamic MRI; Treatment response; gadolinium; adult; aged; Article; cancer diagnosis; cancer recurrence; contrast enhancement; controlled study; female; gold standard; human; image subtraction; liver cell carcinoma; liver parenchyma; major clinical study; male; nuclear magnetic resonance imaging; predictive value; radiofrequency ablation; retrospective study; tumor ablation; tumor growth

Citation Information

Scopus Citations: 1

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