Advanced imaging techniques in the therapeutic response of transarterial chemoembolization for hepatocellular carcinoma

World J Gastroenterol. 2016 May 28;22(20):4835-47. doi: 10.3748/wjg.v22.i20.4835.


Hepatocellular carcinoma (HCC) is one of the major causes of morbidity and mortality in patients with chronic liver disease. Transarterial chemoembolization (TACE) can significantly improve the survival rate of patients with HCC and is the first treatment choice for patients who are not suitable for surgical resections. The evaluation of the response to TACE treatment affects not only the assessment of the therapy efficacy but also the development of the next step in the treatment plan. The use of imaging to examine changes in tumor volume to assess the response of solid tumors to treatment has been controversial. In recent years, the emergence of new imaging technology has made it possible to observe the response of tumors to treatment prior to any morphological changes. In this article, the advances in studies reporting the use of computed tomography perfusion imaging, diffusion-weighted magnetic resonance imaging (MRI), intravoxel incoherent motion, diffusion kurtosis imaging, magnetic resonance spectroscopy, magnetic resonance perfusion-weighted imaging, blood oxygen level-dependent MRI, positron emission tomography (PET)/computed tomography and PET/MRI to assess the TACE treatment response are reviewed.

Keywords: Blood oxygen level-dependent; Chemoembolization; Computed tomography perfusion imaging; Diffusion kurtosis imaging; Diffusion-weighted imaging; Hepatocellular carcinoma; Intravoxel incoherent motion; Magnetic resonance perfusion-weighted imaging; Magnetic resonance spectroscopy.

Publication types

  • Review

MeSH terms

  • Carcinoma, Hepatocellular / diagnostic imaging*
  • Carcinoma, Hepatocellular / pathology
  • Carcinoma, Hepatocellular / therapy*
  • Chemoembolization, Therapeutic*
  • Diagnostic Imaging / methods*
  • Humans
  • Liver Neoplasms / diagnostic imaging*
  • Liver Neoplasms / pathology
  • Liver Neoplasms / therapy*
  • Magnetic Resonance Imaging
  • Magnetic Resonance Spectroscopy
  • Multimodal Imaging
  • Perfusion Imaging
  • Positron-Emission Tomography
  • Predictive Value of Tests
  • Reproducibility of Results
  • Tomography, X-Ray Computed
  • Treatment Outcome
  • Tumor Burden