title: Hepatic imaging following intra-arterial embolotherapy.
abstract: To discuss guidelines and salient imaging findings of solid tumors treated with common intra-arterial procedures used in interventional oncology.
  
  
  
  A meticulous literature search of PubMed-indexed articles was conducted. Key words included "imaging + embolization," "imaging + TACE," "imaging + radioembolization," "imaging + Y90," "mRECIST," and "EASL." Representative post-treatment cross-sectional images were obtained from past cases in this institution.
  
  
  
  Intra-arterial therapy (IAT) in interventional oncology includes bland embolization, chemoembolization, and radioembolization. Solid tumors of the liver are the primary focus of these procedures. Cross-sectional CT and/or MR are the main modalities used to image tumors after treatment. Traditional size-based response criteria (WHO and RECIST) alone are of limited utility in determining response to IAT; tumoral necrosis and enhancement must be considered. Specifically for HCC, the EASL and mRECIST guidelines are becoming widely adopted response criteria to assess these factors. DWI, FDG-PET, and CEUS are modalities that play an adjunctive but controversial role.
  
  
  
  Radiologists must be aware that the different forms of intra-arterial therapy yield characteristic findings on cross-sectional imaging. Knowledge of these findings is integral to accurate assessment of tumor response and progression.
authors.affiliation: Department of Radiology, Section of Interventional Radiology, Northwestern Memorial Hospital, Robert H. Lurie Comprehensive Cancer Center, 676 N. St. Clair, Suite 800, Chicago, IL, USA.
authors.forename: Joseph Ralph
authors.initials: JR
authors.lastname: Kallini
authors.affiliation: Department of Radiology, Northwestern University Feinberg School of Medicine, Northwestern Memorial Hospital, 676 North Saint Clair Street, Suite 800, Chicago, IL, 60611, USA.
authors.forename: Frank H
authors.initials: FH
authors.lastname: Miller
authors.affiliation: Department of Radiology, Section of Interventional Radiology, Northwestern Memorial Hospital, Robert H. Lurie Comprehensive Cancer Center, 676 N. St. Clair, Suite 800, Chicago, IL, USA.
authors.forename: Ahmed
authors.initials: A
authors.lastname: Gabr
authors.affiliation: Department of Radiology, Section of Interventional Radiology, Northwestern Memorial Hospital, Robert H. Lurie Comprehensive Cancer Center, 676 N. St. Clair, Suite 800, Chicago, IL, USA.|Department of Surgery, Division of Transplantation, Comprehensive Transplant Center, Northwestern University, Chicago, IL, USA.|Department of Medicine, Division of Hematology and Oncology, Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, IL, USA.
authors.forename: Riad
authors.initials: R
authors.lastname: Salem
authors.affiliation: Department of Radiology, Section of Interventional Radiology, Northwestern Memorial Hospital, Robert H. Lurie Comprehensive Cancer Center, 676 N. St. Clair, Suite 800, Chicago, IL, USA. r-lewandowski@northwestern.edu.
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Lewandowski
mesh_terms: D016461:Chemoembolization, Therapeutic / Q000379:methods; D004621:Embolization, Therapeutic / Q000379:methods*; D006801:Humans; D008113:Liver Neoplasms / Q000000981:diagnostic imaging* / Q000628:therapy*; D053783:Magnetic Resonance Imaging, Interventional; D015641:Radiography, Interventional
keywords: Computed tomography (CT); HCC; Intra-arterial embolotherapies; MR imaging; Modified RECIST (mRECIST); Response assessment