الفهرس 
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Abstract
Hepatocellular carcinoma (HCC) is considered to be one of the
most common malignancies worldwide. According to the stage of the
disease, treatment of HCC is based on transplantation, resection,
ablation, embolization and finally medical/ supportive treatment.
Unfortunately, the vast majority of patients with HCC are not
suitable for any of the surgical treatment options. Trans-catheter arterial
chemoembolization (TACE) is minimally invasive option that may
achieve the pertinent balance in successful tumor eradication and
maximal preservation of liver function. It has become one of the most
common forms of interventional therapy.
The aim of this study is to assess the role of triphasic CT in
prediction of the tumor response of HCC patients who had locally treated
with transcatheter arterial chemoembolization by studying the size,
location, margin, enhancement and multiplicity of the HCC after TACE.
To achieve this aim, 50 patients (37 male and 13 female, mean age
58 years) with diagnosed HCC were treated by TACE. The procedure
was performed after informed written consent was obtained from all
patients.
This prospective study included 50 patients (M/F 37/13) with age
distribution from 33 years to 72 years old of those had diagnosed HCC.
All patients underwent complete history taking, clinical examination,
laboratory investigations then triphasic MDCT examination of the liver
as a base line assessment then patients were treated with TACE.
Finally, the therapeutic response was evaluated after 21 days by
triphasic MDCT scan of liver according to modified RECIST criteria.
Complete response was achieved in 46%, partial response in 44%,
stable disease in 8% and progressive disease in 2%.
Pre-treatment imaging characteristics of HCC lesions are
predictive of complete necrosis following TACE. If certain
characteristics are found to be associated with response, then patients
with HCC exhibiting these characteristics would be more likely to
benefit from TACE. In HCC without favorable characteristics,
alternative or adjuvant treatments or even no treatment may be
considered.
The most important findings from this study were the
identification of pre-TACE imaging HCC tumor characteristics that are
predictive of tumor necrosis after TACE. We found that small, solitary,
well defined typically enhanced and peripherally located HCC tumors
were predictive of complete and partial response while large, multiple,
ill defined , atypically enhanced and centrally located tumors were
predictive of stable and progressive disease.