Abstract
Interventional radiology has contributed to an improvement in life expectancy in patients with malignant hepatic tumors. Radiofrequency ablation (RFA) and transarterial chemoembolization (TACE) for hepatocellular carcinoma have been widely performed. Sonography, computed tomography (CT), and magnetic resonance imaging (MRI), as well as several image fusion techniques, are performed to evaluate the completeness of the procedure and treatment course. The goal of RFA is complete ablation of a tumor with an adequate circumferential safety margin for the treatment; however, assessment of technical success is sometimes difficult in cases without the combination of conventional TACE (cTACE). The goal of TACE is also complete embolization of a tumor with a safe margin. In cTACE with iodized oil and gelatin sponge particles, the embolized area can be easily assessed on CT or cone-beam CT because iodized oil is highly radiopaque. However, peritumoral recurrence is frequently missed due to beam hardening artifacts from iodized oil in the tumor, especially in cases treated with superselective cTACE. Therefore, CT and MRI should be performed in turn in the follow-up. On the other hand, in TACE with drug-eluting beads (DEB-TACE), CT and MRI can show similar residual tumor and rating of treatment results.
