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World J Gastroenterol. Jul 14, 2022; 28(26): 3116-3131
Published online Jul 14, 2022. doi: 10.3748/wjg.v28.i26.3116
Role of gadoxetic acid-enhanced liver magnetic resonance imaging in the evaluation of hepatocellular carcinoma after locoregional treatment
Marco Gatti, Cesare Maino, Fatemeh Darvizeh, Alessandro Serafini, Eleonora Tricarico, Alessia Guarneri, Riccardo Inchingolo, Davide Ippolito, Umberto Ricardi, Paolo Fonio, Riccardo Faletti
Marco Gatti, Alessandro Serafini, Paolo Fonio, Riccardo Faletti, Department of Surgical Sciences, University of Turin, Turin 10126, Italy
Cesare Maino, Davide Ippolito, Department of Diagnostic Radiology, University of Milano-Bicocca, Monza 20900, Italy
Cesare Maino, Davide Ippolito, Department of Diagnostic Radiology, Ospedale San Gerardo, Monza 20900, Italy
Fatemeh Darvizeh, School of Medicine, Vita-Salute San Raffaele University, Milan 20121, Italy
Eleonora Tricarico, Department of Radiology, "F. Perinei" Hospital, Altamura (BA) 70022, Italy
Alessia Guarneri, Umberto Ricardi, Department of Oncology, University of Turin, Turin 10126, Italy
Riccardo Inchingolo, Interventional Radiology Unit, “F. Miulli” Regional General Hospital, Acquaviva delle Fonti (BA) 70021, Italy
Author contributions: Gatti M was involved in conception and design of the study; Gatti M, Maino C, Serafini A and Tricarico E were involved in literature review, analysis and writing of the original draft; Darvizeh F was involved in writing of the original draft; Guarneri A, Inchingolo R, Ippolito D, Ricardi U and Fonio P took part in supervision of the study; Faletti R took part in supervision of the study and is the guarantor of the study; all the authors worked together to editing, reviewing and final approval of article.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (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: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Marco Gatti, MD, Research Fellow, Department of Surgical Sciences, University of Turin, Via Genova 3, Turin 10126, Italy. marcogatti17@gmail.com
Received: February 25, 2022
Peer-review started: February 25, 2022
First decision: April 5, 2022
Revised: April 25, 2022
Accepted: June 16, 2022
Article in press: June 16, 2022
Published online: July 14, 2022
Processing time: 137 Days and 15.8 Hours
Abstract

Locoregional treatments, as alternatives to surgery, play a key role in the management of hepatocellular carcinoma (HCC). Liver magnetic resonance imaging (MRI) enables a multiparametric assessment, going beyond the traditional dynamic computed tomography approach. Moreover, the use of hepatobiliary agents can improve diagnostic accuracy and are becoming important in the diagnosis and follow-up of HCC. However, the main challenge is to quickly identify classical responses to loco-regional treatments in order to determine the most suitable management strategy for each patient. The aim of this review is to provide a summary of the most common and uncommon liver MRI findings in patients who underwent loco-regional treatments for HCC, with a special focus on ablative therapies (radiofrequency, microwaves and cryoablation), trans-arterial chemoembolization, trans-arterial radio-embolization and stereotactic ablative radiotherapy techniques, considering the usefulness of gadoxetate disodium (Gd-EOB-DTPA) contrast agent.

Keywords: Carcinoma; Hepatocellular; Magnetic resonance imaging; Gd-EOB-DTPA; Radiofrequency ablation; Catheter ablation; Ablation techniques

Core Tip: Ablation techniques are useful tools in the treatment of patients with hepatocellular carcinoma, both in case with a small lesion and as a bridging option prior to surgical resection or liver transplantation and in addition to palliative treatment in advanced disease. In clinical practice it is of utmost importance to acquire a specific skill to identify classical magnetic resonance imaging appearance of the treated lesion and for early detection of tumor recurrence, to guarantee the best possible management for each patient.