Abstract: Objective To evaluate the efficacy of magnetic resonance imaging (MRI) with diffusion-weighted imaging (DWI) combined with dual-source CT in patients with primary liver cancer after transcatheter arterial chemoembolization (TACE). Methods A total of 117 patients with primary liver cancer (PLC) admitted to our hospital between June 2022 and December 2024 were selected. The apparent diffusion coefficient (ADC), start time (TTS), hepatic artery perfusion volume (ALP), blood volume (RV), hepatic perfusion index (HPI) and portal vein perfusion volume (PVP) were detected by MRI-DWI and dual-source CT. Receiver operating characteristic (ROC) curve was plotted, and the area under the curve (AUC) was used to evaluate the value of dual-source CT perfusion imaging parameters combined with CT in predicting residual lesion area after TACE. Results Before operation, 46 cases had non-uniform hyperperfusion and 71 cases had uniform ALP perfusion. PVP showed low perfusion. One month after operation, the results showed that 85 cases of ALP showed high perfusion, site defect or iodol deposition in the lesion. 32 cases of ALP showed no perfusion and intrafocal perfusion fluid was uniformly deposited. One month after surgery, ADC value and PVP in residual lesion were (1.3±0.1) ×10^-3 mm²/s and (8.0±1.6) [mL/ (100 mL·min^-1)], respectively, significantly lower than the values before operation [(1.5±0.2) ×10^-3 mm²/s, (10.2±2.6) [mL/ (100mL·min^-1)], P<0.05]. ALP and HPI were (48.3±6.8) [mL/ (100 mL·min^-1)] and (82.3±6.5) %, respectively, which was significantly higher than that those before operation [(37.4±5.9) [mL/ (100 mL·min^-1)] and (74.1±5.8) %, respectively, P<0.05]. One month after surgery, ADC, TTS and PVP in the completely embolized zone were (1.8±0.4) ×10^-3 mm²/s, (12.1±2.9) s, (46.3±5.9) [mL/ (100 mL·min^-1)], respectively, significantly higher than preoperative values of (1.5±0.2) ×10^-3 mm²/s, (6.2±1.4) s, (10.3±2.7) [mL/ (100 mL·min^-1) (P<0.05). ALP, RV and HPI were (16.3±3.2) [mL/ (100 mL·min^-1)], (4.9±1.5) mL/100 mL, (20.3±3.1) %, respectively, which was significantly lower than that before operation [(37.9±5.4) [mL/ (100 mL·min^-1)], (12.3±2.7) mL/100 mL, (73.6±5.3) %, P<0.05]. ROC analysis showed that the specificity and sensitivity of residual area after TACE were 93.8%, 90.6% and 0.909 respectively. Conclusion ADC value, PVP and ALP combined with HPI have important value in predicting the postoperative efficacy of TACE in patients with primary liver cancer.

Key words: Magnetic resonance imaging, Diffusion-weighted imaging, Dual-source CT, Primary liver cancer, Transcatheter arterial chemoembolization, Curative effect, Predictive value