Lipiodol Retention Pattern After cTACE as predictor For Disease Response in HCC Lesions with Complete Response According to mRECIST in Egyptian Patients

Abstract

Background: Hepatocellular carcinoma (HCC) in Egypt represents the fourth common cancer. It is the leading cause of death and morbidity-related cancer. Loco regional treatments that employ image guidance has a big role in the management of patients with HCC, cTACE (conventional trans arterial chemo embolization) is the reference treatment in HCC intermediate stage according to the BCLC (Barcelona Clinic Liver Cancer) guidelines, in which patients who are not suitable for curative treatment like ablation, surgery, or liver transplant. This enlarged the possibility of interventional radiologists in the treatment of HCC.Objective: Investigating the differential disease response of HCCs with a CR (complete response) in the horizon of mRECIST (modified response evaluation criteria in solid tumors) after the cTACE session based on complete and incomplete lipiodol retention pattern.Materials and Methods: In our research work, we had two groups each with 10 patients (i.e. total number of patients are 20), each group depict the two patterns of lipiodol retention (complete Vs in incomplete retention post cTACE considering mRECIST criteria with (CR) complete response) and its relation to the disease progression on following up those patientsResults: There’s a relation between the lipiodol retention and the disease response regarding its course of progression or not, in cases with incomplete lipiodol retention after cTACE even if their response according to mRECIST was complete, then there was increased chance by 80 % of disease progression, another session of cTACE is recommended. compared to the other group of with complete lipiodol retention the chance of locally disease progression is 30 %Conclusion: After the first session of cTACE, Local progression appears to be especially relevant in cases of incomplete lipiodol retention, and patients seem to require retreatment. On the other hand, patients who had complete lipiodol retention, who has subsequently a significantly lower probability of local progression, may benefit from MR imaging to detect viable tumor remains if clinically suspected.