Thesis (M.Sc.) - Cairo University - Faculty of Medicine - Department of Radio-diagnosis

Objectives: To evaluate the performance of Liver Imaging Reporting and Data system Treatment Response (LR-TR) algorithm for the assessment of loco-regionally treated hepatocellular carcinoma. Material and Methods: The study was conducted on 40 patients diagnosed with HCC, treated with locoregional therapy (LRT) at our institute between 2017 and 2019, who came for follow up to assess therapy response and to plan the next step in treatment. Imaging response was evaluated according to LIRADS TR algorithm and compared to modified Response Evaluation Criteria in Solid Tumors (mRECIST) arterial phase hyperenhancement (APHE) criterion. Reference standard for 2viable3 tumors in treated observations included presence of well-defined strong tumor stain on cone-beam CT angiography followed by TACE (< 6 weeks from the CT or MRI) which also shows dense accumulation of iodized oil in the target lesion. On the other hand, reference standard for 2nonviable3 tumors included stable or decreased lesion size on the follow-up dynamic CT or MRI ({u2265} 6 months from the initial follow up) without any additional treatment. Results: When equivocal observations were considered as LR-TR viable, LR-TR viable resulted in 92.6 % sensitivity, 92.31% specificity and 92.5 % accuracy. On the other side when equivocal observations were considered as LR-TR nonviable, it resulted in decreasing the sensitivity to 88.89% but increased the specificity to 100% with no effect on the accuracy (92.5%).The mRECIST criteria for viable tumors (presence of APHE) showed sensitivity of 92.59% and specificity of 69.23%

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