Role of Multi-Detector Computed Tomography in Tumor Response Evaluation of Conventional Trans-Arterial Chemoembolization in Hepatocellular Carcinoma

Abstract

Background: The major liver cancer that affects people the most frequently is hepatocellular carcinoma (HCC). Transcatheter arterial chemoembolization (TACE), which combines the effects of targeted chemotherapy with ischemia necrosis brought on by arterial embolization, reduces tumor growth and increases survival. Conventional methods for evaluating therapy response, such as Response Evaluation Criteria in Solid Tumours (RECIST), which is based on tumor size reduction, perform inadequately in predicting the course of TACE treatment for HCC patients. Aim: To compare the currently available non-3D three-dimensional methods (modified RECIST) with the quantitative method of the index tumor as a modern and more accurate tool for evaluating the response of one of the most common tumors, HCC, after the treatment by TACE. Methods: We conducted a prospective comparative study on 55 patients with a diagnosis of HCC who underwent cTACE at the interventional radiology unit. Each participant was subjected to History Taking, laboratory investigations, and pathology assessment. Results: Most patients 42 (76.4%) were responders, while 13 (23.6%) were non-responders regarding the treatment response according to vRECIST. By both mRECIST and vRECIST methods in the assessment of the therapeutic response, it was found that both methods agree in the assessment of 11 patients had a partial response, nine patients had stable disease, four patients had a complete response, and two patients had progressive disease. Conclusion: With a significant difference between vRECIST and mRECIST in the assessment of therapeutic response, volumetric analysis is an efficient method for measuring HCC lesions and evaluating their response to locoregional treatment.