Imaging assessment of hepatocellular carcinoma response to locoregional and systemic therapy

OBJECTIVE. This article focuses on imaging techniques and imaging findings after locoregional and systemic therapy in patients with hepatocellular carcinoma (HCC). We discuss currently available locoregional and systemic therapies for HCC, imaging modalities and protocols used to assess HCC response, criteria for assessing HCC response, imaging appearances of treated HCC, and future directions. CONCLUSION. The evaluation of tumor response after systemic and locoregional therapies is essential in directing management for HCC. An understanding of the various therapeutic strategies and of their posttherapy imaging appearances is essential for accurately assessing treatment response. The evaluation of tumor response should include not only anatomic imaging biomarkers, such as reduction in tumor size, but also tumor enhancement and necrosis.