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World J Radiol. Oct 28, 2025; 17(10): 108804
Published online Oct 28, 2025. doi: 10.4329/wjr.v17.i10.108804
Hepatocellular carcinoma treatment response: Imaging findings and criteria
Francesco Agnello, Adele Taibbi, Massimo Galia, Alessia Orlando, Cesare Gagliardo, Tommaso Vincenzo Bartolotta
Francesco Agnello, Adele Taibbi, Massimo Galia, Alessia Orlando, Cesare Gagliardo, Tommaso Vincenzo Bartolotta, Department of Radiology, University Hospital "Paolo Giaccone", Palermo 90127, Italy
Author contributions: Agnello F, Galia M and Bartolotta TV were guarantors of the integrity of the study; Agnello F, Galia M, Gagliardo C and Orlando A contributed to the manuscript drafting and revision; Bartolotta V and Galia M contributed to manuscript editing. All authors contributed to literature search and approved the final version of the paper.
Conflict-of-interest statement: Authors have no conflict of interest.
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: Tommaso Vincenzo Bartolotta, MD, PhD, Full Professor, Department of Radiology, University Hospital "Paolo Giaccone", Via del Vespro 129, Palermo 90127, Italy. tommasovincenzo.bartolotta@unipa.it
Received: April 24, 2025
Revised: June 16, 2025
Accepted: September 17, 2025
Published online: October 28, 2025
Processing time: 187 Days and 19.9 Hours
Abstract

Imaging plays a crucial role in the evaluation of hepatocellular carcinoma (HCC) treatment response. Contrast enhanced computed tomography and magnetic resonance imaging with extra-cellular or hepatobiliary contrast agents are the imaging techniques of choice. Contrast enhanced ultrasound is a promising technique. In this paper, we describe radiological techniques, imaging findings after HCC treatment, and the criteria of response evaluation. The utility of the structured report is also evaluated.

Keywords: Hepatocellular carcinoma; Treatment response; Response Evaluation Criteria in Solid Tumors 1.1; Modified Response Evaluation Criteria in Solid Tumors; Liver Imaging Reporting and Data System; Structured report

Core Tip: Computed tomography and magnetic resonance imaging play a crucial role in the evaluation of hepatocellular carcinoma (HCC) treatment response. Contrast enhanced ultrasound is a promising technique. Familiarity with imaging criteria is crucial to improve management of cirrhotic patients with HCC. In this review, we describe therapeutic options, radiological techniques, and imaging criteria to evaluate HCC treatment, and usage of a structured report.