Vascular invasion in hepatocellular carcinoma developed after direct-acting antiviral therapy: CT and MRI assessment

Background The effects of direct-acting antivirals (DAAs) on vascular invasion after curative hepatocellular carcinoma (HCC) treatment remain controversial. Thus, this work aimed to assess the vascular invasion of HCC after DAAs treatment via imaging by computerized tomography (CT) and magnetic resonance imaging (MRI). Methods This case-control study was carried out on 102 cases, 18 years or older, both sexes, with HCV-related HCC. Patients were divided into equal groups; Patients treated with DAAs (group I), and patients who were not treated with DAAs (group II). Group I received two different regimes of DAA dose, 12 weeks of sofosbuvir (400 mg)/velpatasvir (100 mg) once a day and 12 weeks of sofosubuvir 400g/daclatasvir 60g once a day. Results Microvascular invasion occurred in 16 (31.37%) patients in group I, and in 5 (9.8%) patients in group II. Portal invasion occurred in 23 (45.1%) patients in group I, and in 9 (17.65%) patients in group II. size of lesions, no enhancement, nodal and pulmonary deposits were significantly increase in group I than group II (P < 0.05). Site of lesions was significantly different between both groups. Comparing group, I to group II, heterogeneous enhancement was significantly decreased (P < 0.001). Focal lesions, peripheral and homogenous enhancements, and bone deposits were insignificantly different between both groups. Conclusions DAAs had a potential impact on the characteristics and distribution of HCC lesions. DAAs were associated with an increase in incidence of microvascular invasion, portal vein invasion, lesion size, and the presence of nodal and pulmonary deposits.