Comparative Study Between Subtraction MR And Conventional Catheter Angiography in Assessment of Residual HCC

Background: In Egypt, hepatocellular carcinoma (HCC) is a significant reason for morbidity, mortality, and the high cost of maintaining health care.Aim: To compare subtraction MR and conventional catheter angiography in the assessment of the management of recurrent/residual HCC and their impact on changing clinical decisions.patients and methods: This prospective research was performed from 2020 to 2023 on 60 patients that underwent TACE procedures referred from outpatient clinic of medical & surgical oncology department.Results: There was highly significant increase in Contrast-enhanced MRI enhancement, Subtraction MRI Enhancement, & DW-MRI restriction, in Residual disease group; compared to complete treatment group (p-value less than 0.0001 respectively). By utilizing ROC-curve analysis, Contrast-enhanced MRI detected cases having residual disease from successfully treated cases, with good (88%) accuracy, sensitivity= 100%, and specificity= 77% (p-value less than 0.01). Subtraction MRI detected cases of residual disease from successfully treated cases with excellent (97%) accuracy, sensitivity= 100%, and specificity= 95% (p-value less than 0.01). DW-MRI detected cases of residual disease from successfully treated cases, with good (83%) accuracy, sensitivity= 87%, and specificity= 79% (p-value less than 0.01). Tumoral activity at Angiography detected cases of residual disease from successfully treated cases, with good (84%) accuracy, sensitivity= 87%, and specificity= 81% (p-value less than 0.01).Conclusion: A confirmative post-processing application, Subtraction MRI, improves the confidence of radiologists in interpreting the medical response of HCC following TACE and assists in the clinical treatment of those requiring retreatment sessions when combined with DWI techniques.