How is response to TAE and TACE monitored?
Posttreatment monitoring is performed with contrast-enhanced multiphase computed tomography (CT) or dynamic magnetic resonance imaging (MRI) 4 to 6 weeks after all tumor-bearing areas are treated. If treatment of both lobes of the liver is planned, imaging between sessions may be performed based on operator preference. Signs of tumor necrosis on CT include uptake of ethiodized oil (conventional TACE only) and absence of arterial-phase enhancement when present prior to therapy (see Figure 68-1 ). The principal determinant of tumor necrosis on MRI is also the absence of arterial enhancement when present prior to treatment.