Thesis (Ph.D.) - Cairo University - Faculty of Medicine - Department of Radio- Diagnosis

Objective: To study the role of CT perfusion imaging technique in evaluation of hepatocellular carcinoma treatment response through monitoring changes in perfusion parameters. Methods: The study was conducted on 70 patients diagnosed with HCC, treated with loco-regional therapy between 2019 and 2020, who came for follow up to assess therapy response and to plan the next step in treatment. Imaging response was evaluated according to CT perfusion parameters. Results:Our results demonstrated that post local-treatment CTP of the recurrent tumor confirmed relative increased BFand BV and reduced MTT relative to the background values of the cirrhotic hepatic parenchyma. The recurrent HCC post-TACE shows BF=292.79±150.16, BV=15.68± 5.69 and MTT=6±2.78. The recurrent HCC post-RFA shows BF= 565.80±257.33, BV= 47.50±10.03and MTT= 7.53± 3.16. The CTP of the ablated lesions post local-treatment confirmed decreased BF and BV and increased MTTrelative to the background values of the cirrhotic hepatic parenchyma. Conclusion:CT perfusion technique showed good diagnostic performance, with high specificity and sensitivity which increased when equivocal lesions where considered as viable with lesser effect on specificity and no effect on overall accuracy. Perilesional hyperemia shouldn{u2019}t be considered as an evidence of residual viable tumor and should be differentiated from arterial phase hyperenhancement of true viable residual

Issued also as CD