Hepatic imaging following intra-arterial embolotherapy

Joseph Ralph Kallini, Frank H. Miller, Ahmed Gabr, Riad Salem, Robert J. Lewandowski*

*Corresponding author for this work

Research output: Contribution to journalReview article

18 Scopus citations

Abstract

Purpose: To discuss guidelines and salient imaging findings of solid tumors treated with common intra-arterial procedures used in interventional oncology. Methods: A meticulous literature search of PubMed-indexed articles was conducted. Key words included “imaging + embolization,” “imaging + TACE,” “imaging + radioembolization,” “imaging + Y90,” “mRECIST,” and “EASL.” Representative post-treatment cross-sectional images were obtained from past cases in this institution. Results: Intra-arterial therapy (IAT) in interventional oncology includes bland embolization, chemoembolization, and radioembolization. Solid tumors of the liver are the primary focus of these procedures. Cross-sectional CT and/or MR are the main modalities used to image tumors after treatment. Traditional size-based response criteria (WHO and RECIST) alone are of limited utility in determining response to IAT; tumoral necrosis and enhancement must be considered. Specifically for HCC, the EASL and mRECIST guidelines are becoming widely adopted response criteria to assess these factors. DWI, FDG-PET, and CEUS are modalities that play an adjunctive but controversial role. Conclusions: Radiologists must be aware that the different forms of intra-arterial therapy yield characteristic findings on cross-sectional imaging. Knowledge of these findings is integral to accurate assessment of tumor response and progression.

Original languageEnglish (US)
Pages (from-to)600-616
Number of pages17
JournalAbdominal Radiology
Volume41
Issue number4
DOIs
StatePublished - Apr 1 2016

Keywords

  • Computed tomography (CT)
  • HCC
  • Intra-arterial embolotherapies
  • MR imaging
  • Modified RECIST (mRECIST)
  • Response assessment

ASJC Scopus subject areas

  • Radiological and Ultrasound Technology
  • Radiology Nuclear Medicine and imaging
  • Gastroenterology
  • Urology

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