Assessment of tumor response on MR imaging after locoregional therapy

Assessment of tumor response after locoregional therapies is important in determining treatment success and in guiding future therapy. Magnetic resonance imaging plays an important role in evaluating treatment response to new therapies directed toward hepatic lesion treatment. The traditional and accepted criteria to determine tumor response in oncology, namely the Response Evaluation Criteria in Solid Tumors (RECIST) and the European Association for the Study of the Liver (EASL) criteria, use decrease in tumor size and lesion enhancement as an indicator of successful therapy. A more recent evaluation method is the Apparent Diffusion Coefficient (ADC) measured by diffusion-weighted MR imaging. Diffusion-weighted MR imaging and ADC values map the thermally induced motion of water molecules in tissues and thereby are able to provide insight into tumor microstructure. In this article we discuss the role of MR imaging in assessing treatment response after various locoregional therapies. We describe the role of tumor size and lesion enhancement as well as ADC mapping. We also discuss the magnetic resonance imaging findings after radiofrequency ablation (RFA), transarterial chemoembolization (TACE) and radioembolization.