Abstract
Background
Interventional therapies for hepatocellular carcinoma (HCC) include various methods
such as transarterial chemoembolization (TACE), radiofrequency and microwave ablation
(RFA, MWA), selective internal radiotherapy (SIRT), and stereotactic body radiation
therapy (SBRT). Imaging follow-up using magnetic resonance imaging (MRI) is essential
for the early detection of recurrence, but requires profound knowledge of therapy-related
imaging changes.
Materials & Methods
A structured PubMed literature search covering the period from 2000 to 2025 was conducted
using the keywords “hepatocellular carcinoma,” “magnetic resonance imaging,” “thermal
ablation,” “transarterial chemoembolization,” “transarterial radioembolization,” “stereotactic
body radiotherapy,” and “treatment response.” In addition, the study incorporated
current national and international guidelines, as well as institutional clinical experience.
Results
Post-interventional imaging changes on MRI vary depending on the therapeutic approach
applied. Typical morphological changes are observed immediately after thermoablation
and TACE, whereas therapeutic effects of SIRT and SBRT become clearly evident only
after weeks to months. Profound knowledge of standardized evaluation systems such
as mRECIST, EASL, and LI-RADS-TR is crucial to ensure a precise and structured assessment
of therapeutic response.
Conclusion
Knowledge of specific MRI findings and standardized assessment systems is essential
for structured follow-up of hepatocellular carcinoma after interventional therapy.
Limitations arise from the heterogeneity of imaging findings, variable temporal patterns,
and potential influences of combination therapies. Systemic therapies were not considered,
restricting generalizability.
Key Points
-
Magnetic resonance imaging is essential for assessing treatment response and for the
early detection of recurrence after interventional therapy of hepatocellular carcinoma.
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Morphological changes after therapy are procedure-dependent and show marked differences
over time: SIRT and SBRT demonstrate delayed changes, whereas TACE and thermal ablation
present immediate effects.
-
Standardized classification systems (mRECIST, EASL, LI-RADS-TR) provide a structured
and reproducible framework for evaluating treatment response.
-
Knowledge of characteristic imaging findings and potential pitfalls is crucial to
reliably differentiate between residual tumor, recurrence, and therapy-induced changes.
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This review contributes to the current body of knowledge by systematically consolidating
available evidence and presenting it in a practice-oriented manner in the context
of MRI follow-up imaging.
Citation Format
Keywords
hepatocellular carcinoma - interventional procedures - MR-imaging - abdomen
