Hepatocellular carcinoma is a common malignancy which, in specific stages, benefits from
transarterial chemoembolization. The survival of treated patients depends on the accurate
interpretation of follow-up studies after the procedure, with focus on the early detection of
residual tumor or tumor recurrence. Dynamical contrast enhanced CT and MRI are sensitive
methods in evaluating tumor response, although diffusion weighted imaging and other new
modalities can improve the diagnostic role of these tests. A strong knowledge of common
and rare imaging signs of neoplastic tissue in a chemoembolized nodule can lead to a prompt
and effective complementary treatment. Some lesions related to the endovascular intervention
mimic tumor behavior and should always be sought and correctly identified, in order to
avoid unnecessary treatment and impacts in the patient's quality of life.
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