Assessment of tumor response after transarterial chemoembolization in hepatocellular carcinoma patients using dynamic subtraction and diffusion-weighted MRI

Background Transarterial chemoembolization (TACE) represents the conventional therapeutic approach for individuals with multinodular hepatocellular carcinoma (HCC) who exhibit retained hepatic function, lack cancer accompanying manifestations, and show no signs of intravascular tumor infiltration or metastatic spread beyond the liver. Aim This research evaluate the therapeutic efficacy in HCC to TACE through the application of dynamic subtraction and diffusion-weighted MRI. Patients and methods This study was conducted prospectively on 30 participants of both sexes with diagnosed HCC who underwent TACE and had satisfactory liver and renal function. Results Diffusion-weighted image (DWI) demonstrated 90% sensitivity, 100% specificity, 100% positive predictive value, 86% negative predictive value, and a 94% overall diagnostic efficacy when compared to subtraction MRI. In contrast, the dynamic contrast-enhanced MRI demonstrated 97% sensitivity, 100% specificity, 100% positive predictive value, and 96% negative predictive value, and a diagnostic efficacy of 98% relative to subtraction MRI. Conclusion MRI serves as a highly effective modality for evaluating tumor viability and detecting posttreatment complications following TACE. An optimal imaging protocol should incorporate dynamic contrast-enhanced sequences along with postprocessed subtraction images to enhance tissue characterization. DWI offers a viable alternative for patients contraindicated for gadolinium-based contrast agents, and it can be utilized to assess tumor necrosis, particularly in mass HCC lesions. However, relative to DWI, subtraction MRI holds superior diagnostic value, as it significantly improves radiologists’ assurance in interpreting therapeutic outcomes following locoregional interventions for HCC.