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Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. May 28, 2016; 22(20): 4835-4847
Published online May 28, 2016. doi: 10.3748/wjg.v22.i20.4835
Advanced imaging techniques in the therapeutic response of transarterial chemoembolization for hepatocellular carcinoma
Ke Yang, Xiao-Ming Zhang, Lin Yang, Hao Xu, Juan Peng
Ke Yang, Xiao-Ming Zhang, Lin Yang, Hao Xu, Juan Peng, Sichuan Key Laboratory of Medical Imaging, Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong 637000, Sichuan Province, China
Author contributions: Yang K and Yang L wrote the paper; Zhang XM designed the research; Xu H and Peng J collected the data.
Supported by Projects of Department of Science and Technology of Sichuan Province, No. 2016JY0105.
Conflict-of-interest statement: Authors declare no conflict of interests for this article.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Lin Yang, MD, Sichuan Key Laboratory of Medical Imaging, Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Wenhua Road No. 63, Nanchong 637000, Sichuan Province, China. linyangmd@163.com
Telephone: +86-817-2262223 Fax: +86-817-2222856
Received: February 26, 2016
Peer-review started: February 28, 2016
First decision: March 21, 2016
Revised: March 29, 2016
Accepted: April 20, 2016
Article in press: April 20, 2016
Published online: May 28, 2016
Processing time: 82 Days and 22.6 Hours
Abstract

Hepatocellular carcinoma (HCC) is one of the major causes of morbidity and mortality in patients with chronic liver disease. Transarterial chemoembolization (TACE) can significantly improve the survival rate of patients with HCC and is the first treatment choice for patients who are not suitable for surgical resections. The evaluation of the response to TACE treatment affects not only the assessment of the therapy efficacy but also the development of the next step in the treatment plan. The use of imaging to examine changes in tumor volume to assess the response of solid tumors to treatment has been controversial. In recent years, the emergence of new imaging technology has made it possible to observe the response of tumors to treatment prior to any morphological changes. In this article, the advances in studies reporting the use of computed tomography perfusion imaging, diffusion-weighted magnetic resonance imaging (MRI), intravoxel incoherent motion, diffusion kurtosis imaging, magnetic resonance spectroscopy, magnetic resonance perfusion-weighted imaging, blood oxygen level-dependent MRI, positron emission tomography (PET)/computed tomography and PET/MRI to assess the TACE treatment response are reviewed.

Keywords: Blood oxygen level-dependent; Computed tomography perfusion imaging; Chemoembolization; Diffusion kurtosis imaging; Diffusion-weighted imaging; Hepatocellular carcinoma; Magnetic resonance perfusion-weighted imaging; Intravoxel incoherent motion; Magnetic resonance spectroscopy

Core tip: Imaging studies play an important role in the evaluation of the response to transarterial chemoembolization treatment. The use of imaging to examine changes in tumor size to assess the response of solid tumors to treatment has been controversial. In recent years, the emergence of new imaging technologies has made it possible to observe the response of tumors to treatment prior to any morphological changes. In this article, we present a summary of the most recent information on the role of imaging in assessing the treatment response in hepatocellular carcinomas.