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Abdominal Radiology
Published in: Abdominal Radiology 8/2021

01-08-2021 | Magnetic Resonance Imaging | Special Section: HCC treatment

Assessing locoregional treatment response to Hepatocellular Carcinoma: comparison of hepatobiliary contrast agents to extracellular contrast agents

Authors: Anum Aslam, Amita Kamath, Bradley Spieler, Mark Maschiocchi, Carl F. Sabottke, Victoria Chernyak, Sara C. Lewis

Published in: Abdominal Radiology | Issue 8/2021

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Abstract

Cross-sectional imaging with contrast-enhanced magnetic resonance imaging (MRI) is routinely performed in patients with hepatocellular carcinoma (HCC) to assess tumor response to locoregional therapy (LRT). Current response assessment algorithms, such as the Liver Imaging Reporting and Data System (LI-RADS) treatment response algorithm (TRA), allow assessment using conventional gadolinium-based extracellular contrast agents (ECA) for accurate tumor response assessment following LRT. MRI with hepatobiliary agents (HBA) allows an acquisition of hepatobiliary phase (HBP), which is proven to increase sensitivity for detection of observations in at-risk patients, particularly for findings < 2 cm. The use of HBA is not yet incorporated into the TRA; however, it is increasingly used in clinical practice. Few published studies have evaluated the performance of LI-RADS TRA by applying ancillary features related to HBP that has resulted in category adjustment, enabling more sensitive and unequivocal diagnosis. This may help timely management of viable cases, without a significant loss of specificity in comparison with the ECA-based LI-RADS TRA assessment. In this review, we will describe and compare the imaging appearance of treated HCC on MRI using extracellular and hepatobiliary contrast agents and discuss emerging evidence and pitfalls in the assessment of tumor response following LRT with HBA.
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Metadata
Title
Assessing locoregional treatment response to Hepatocellular Carcinoma: comparison of hepatobiliary contrast agents to extracellular contrast agents
Authors
Anum Aslam
Amita Kamath
Bradley Spieler
Mark Maschiocchi
Carl F. Sabottke
Victoria Chernyak
Sara C. Lewis
Publication date
01-08-2021
Publisher
Springer US
Published in
Abdominal Radiology / Issue 8/2021
Print ISSN: 2366-004X
Electronic ISSN: 2366-0058
DOI
https://doi.org/10.1007/s00261-021-03076-x

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