LI-RADS treatment response assessment of combination locoregional therapy for HCC

Abstract

HCC incidence continues to increase worldwide and is most frequently discovered at an advanced stage when limited curative options are available. Combination locoregional therapies have emerged to improve patient survival and quality of life or downstage patients to curative options. The increasing options for locoregional therapy combinations require an understanding of the expected post-treatment imaging appearance in order to assess treatment response. This review aims to describe the synergy between TACE combined with thermal ablation and TACE combined with SBRT. We will also illustrate expected imaging findings that determine treatment efficacy based on the mechanism of tissue injury using the LI-RADS Treatment Response Algorithm.

Keywords: Arterial phase hyperenhancement; Combination locoregional therapy; Hepatocellular carcinoma; LI-RADS Treatment Response Assessment; SBRT; TACE; Thermal ablation.