Application of Multimodal Magnetic Resonance Imaging in Postoperative Evaluation of Hepatocellular Carcinoma After TACE Surgery

Background: Multimodal magnetic resonance imaging (MRI) offers unique imaging capabilities and advantages over traditional diagnostic methods such as computed tomography (CT) or biopsy. This study explores the value of multimodal MRI in evaluating the recurrence of nodular hepatocellular carcinoma (HCC) following transcatheter arterial chemoembolization (TACE) combined with radiofrequency ablation (RFA) surgery. Methods: A retrospective analysis was conducted on 105 patients with clinically or pathologically confirmed single nodular HCC who received combined TACE and RFA treatment at our hospital between September 2009 and September 2014. Retrograde tracing from the point of recurrence to the follow-up interval was used to divide patients into recurrence, suspicious, and postoperative groups. Localization and observation of signal changes and morphological features in various imaging sequences were performed for tumor recurrence areas and interventional lesions in the combined recurrence group. The receiver operating characteristic (ROC) curve was used to compare the diagnostic thresholds of various sequence signals between the recurrence group and the postoperative group. Logistic regression analysis was performed to calculate the sensitivity and specificity of each imaging sequence in diagnosing suspicious cases, utilizing both signal and morphological characteristics simultaneously. Results: Signal characteristics of the suspicious group: On T1-weighted imaging (T1WI), lesions exhibited low signal intensity and mixed signal patterns. On T2-weighted imaging (T2WI), high signal intensity and mixed signal patterns were observed. Diffusion-weighted imaging (DWI) showed high signal intensity, and the three-dimensional liver acquisition with volume acceleration (LAVA) sequence demonstrated significant enhancement. Morphological characteristics: Most lesions appeared semilunar in shape across the sequences. Diagnostic efficacy: When T1WI, T2WI, DWI, and LAVA sequences were combined, the diagnostic sensitivity and specificity were 85.7% and 94.3%, respectively. Conclusions: Multimodal MRI technology has significant value in the follow-up observation of recurrence areas in nodular primary HCC after TACE combined with RFA intervention.