| Summary: | This study aims to compare the role of both subtraction MRI and Diffusion weighted images in assessment of HCC after trans-arterial chemo embolization (TACE). Patients and methods: 32 patients having 54 HCC lesions underwent TACE. Ages ranged between 59 and 73 years (mean age 59.6); there were 26 males and 6 females. All examinations were performed using Philips 1.5 T MRI (Achieva). Pre contrast: T1, T2W and In phase and out phase gradient echo sequence, dynamic: eTHRIVE technique performed. Subtraction of an unenhanced T1-weighted was from the identical post enhancement sequences in early angiographic and late arterial phases. Diffusion imaging: it was performed using single-shot spin-echo echo-planar imaging with b = 0, 300, 600 mm/s2. DWI was used to create ADC maps. Two readers blinded to each other assessed subtraction of dynamic study and DWI technique to evaluate post treatment response. Results: Reader 1 subtraction dynamic MRI sensitivity = 97%, specificity = 100% PPV = 100% and NPV = 95% compared to 70.59%, 75%, 82.76% and 60% respectively in DWI. Reader 2 subtraction dynamic MRI sensitivity = 97%, specificity = 100% PPV = 100% and NPV = 95% compared to 76.5%, 90%, 92.8% and 69% respectively in DWI. Conclusion: DW-MRI had lower accuracy measures compared to subtraction MRI with increased false negative. DWI may act as a supplementary sequence to compensate for the dynamic MRI in patients who couldn't hold their breath adequately.
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