Spectrum of Imaging Findings and Complications After Hepatic Transarterial Chemoembolization for Liver Tumors

Author:

Zandieh Ghazal1,Yazdaninia Iman1,Afyouni Shadi1,Shaghaghi Mohamadreza1,Borhani Ali1,Mohseni Alireza1,Shaghaghi Shiva2,Liddell Robert3,Kamel Ihab R.1

Affiliation:

1. Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins Medicine, John's Hopkins University, Baltimore, MD

2. Department of Radiology, University of Pennsylvania, Philadelphia, PA

3. Division of Vascular and Interventional Radiology, Russell H. Morgan Department of Radiology and Radiological Sciences, The Johns Hopkins Hospital, Baltimore, MD.

Abstract

Abstract This study reviews the spectrum of imaging findings and complications after transarterial chemoembolization (TACE) for the treatment of primary liver tumors (hepatocellular carcinoma, cholangiocarcinoma) and liver metastases. The review encompasses a spectrum of imaging criteria for assessing treatment response, including the modified Response Evaluation Criteria in Solid Tumors guidelines, tumor enhancement, and apparent diffusion coefficient alterations. We discuss the expected posttreatment changes and imaging responses to TACE, describing favorable and poor responses. Moreover, we present cases that demonstrate potential complications post-TACE, including biloma formation, acute cholecystitis, abscesses, duodenal perforation, arterial injury, and nontarget embolization. Each complication is described in detail, considering its causes, risk factors, clinical presentation, and imaging characteristics. To illustrate these findings, a series of clinical cases is presented, featuring diverse imaging modalities including computed tomography, magnetic resonance imaging, and digital subtraction angiography.

Publisher

Ovid Technologies (Wolters Kluwer Health)

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