Medical Oncologist
CION Cancer Clinics
How response to TACE is measured on your scan | CION Cancer Clinics
After TACE, a contrast CT or MRI is repeated to see how much of the tumour is still alive, not just how big it is. Doctors usually use rules called mRECIST, which measure only the part that still lights up with dye, and read the AFP blood test alongside. This page explains the four possible results, the words on your report and what each result usually means for the next step. At CION Cancer Clinics, a multidisciplinary tumour board weighs your liver function and your scans before recommending any treatment.
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Medically reviewed by Dr. Naresh GunduConsultant Medical Oncologist · MBBS, DNB (Internal Medicine), DM (Medical Oncology, AIIMS) · last reviewed October 2026, next review due October 2027
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On this page
- How do doctors know if TACE has worked?
- What do complete, partial, stable and progressive response mean?
- What happens between TACE and the next decision?
- What do the words on a post-TACE scan report mean?
- What do families often misread on a scan after TACE?
- What can this page not tell you?
- Common questions about measuring response to TACE
The short answer
How do doctors know if TACE has worked?
They repeat a contrast CT or MRI scan a few weeks after TACE and look at how much of the tumour is still alive, not just how big it is. A tumour can stay the same size and still be mostly dead inside. The usual yardstick for this is called mRECIST, and the AFP blood test is read alongside it.
Why size alone misleads
After TACE, the treated tumour often does not shrink quickly. The dead tissue, the oily contrast left behind and some swelling can keep it looking large. What tells the radiologist the tumour is still active is whether it lights up when contrast dye passes through the arteries. Live liver cancer takes up that dye early. Dead tumour does not.
Who this page is for
This page is about primary liver cancer, usually hepatocellular carcinoma (HCC), treated with TACE. If you are on tablets or immunotherapy instead, the rules are a little different, and the page on judging response to systemic treatment explains them. If the cancer in your liver spread from elsewhere, your team may use a different scoring system.
The scan after TACE answers one question: is any part of the tumour still alive?The four results
What do complete, partial, stable and progressive response mean?
Reports sort the result into one of four groups. Each one points the team towards a different next step.
Complete response
No part of the treated tumour lights up in the arterial phase any more. The tumour looks fully dead on the scan. This is the best result a session can give, but it is not the end of watching.
Usually means
- No more TACE for now
- Regular scans and AFP tests from here
Partial response
The live, enhancing part of the tumour has shrunk clearly, by roughly a third or more across the measured tumours. Some of it is still active, so the team often plans another session aimed at what remains.
Stable disease
The live part has neither shrunk enough to count as a response nor grown enough to count as progression. The team weighs whether one more session is worth it or whether another approach makes more sense.
Progressive disease
The live part has grown by roughly a fifth or more, or new tumours have appeared, or the cancer has spread into a blood vessel or beyond the liver. Repeated progression is one sign that TACE has stopped helping.
The page on TACE refractoriness explains what happens then.Not sure whether this applies to you?
Ask an oncologistAfter each session
What happens between TACE and the next decision?
A short wait for the liver to settle
The scan is not done straight away, because swelling and the effects of the procedure can confuse the picture. Your team sets the timing, usually a few weeks after the session.
A contrast CT or MRI
CION arranges a triple-phase CT or a contrast MRI through its diagnostic partners. MRI can be clearer when the oily contrast from conventional TACE hides the tumour on CT.
An AFP blood test
If your AFP was raised before treatment, a fall supports a good response and a rise is a warning. The page on AFP after treatment explains how to read the trend.
Liver function tests
The scan says what happened to the tumour. The blood tests say what happened to the liver. A good response is not worth much if the liver is too weak for the next step.
The tumour board decides
The scan, AFP and liver tests are reviewed together. The team then recommends another session, a pause with watching, or a change of treatment.
On your report
What do the words on a post-TACE scan report mean?
- mRECIST
- Modified RECIST, a set of rules that measures only the live, enhancing part of a liver tumour. It is the usual yardstick after TACE.
- Arterial enhancement
- The tumour lighting up early as dye passes through the arteries. In a treated tumour, it suggests live cancer is still there.
- Viable tumour
- Tumour that is still alive. "Residual viable tumour" means part of it survived treatment.
- Lipiodol deposition
- The oily contrast left behind after conventional TACE. Dense, even lipiodol often goes with a good effect, but it can also hide small live areas on CT.
- LR-TR viable / nonviable
- LI-RADS treatment response categories. Some radiologists use these instead of mRECIST. The LI-RADS page explains the system.
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Commonly believed
What do families often misread on a scan after TACE?
"The tumour is the same size, so TACE did nothing."
Size is a poor guide after TACE. A tumour can stay the same size while most of it has died. The report's comments on enhancement matter far more than the measurement in the first line.
"Complete response means the cancer has gone for good."
It means no live tumour can be seen on that scan. Liver cancer often comes back, in the treated spot or elsewhere in a scarred liver. That is why regular scans continue after a complete response.
"A normal AFP proves the TACE worked."
Some liver cancers never raise AFP at all, so a normal value says little on its own. The scan is the main test. AFP helps most when it was high before treatment.
"If it worked once, we should keep doing TACE."
Each session also takes something from the liver. When the response stops improving, more TACE can do more harm than good. The team looks at the pattern across sessions, not one good result.
Being straight with you
What can this page not tell you?
It cannot read your report for you. The same words can carry different weight depending on how many tumours there are, where they sit and how your previous scans looked. A radiologist who can compare the new images with the old ones, and an oncologist who knows your liver, are the right people to explain it.
Who this does not apply to
These rules are built for liver cancer treated with TACE. After surgery or ablation, follow-up scans look for something slightly different, and the page on the follow-up scan after ablation covers that. People on tablets or immunotherapy are judged with a different version of the rules.
When a second look helps
Reports after TACE can be hard to read, especially with heavy lipiodol on CT. If the result does not match how you feel, or the next step is a big change, asking for the scans to be reviewed again is reasonable. CION's tumour board can review your images and reports and tell you what they show.
Always bring the actual scan images, not only the written report. The comparison is the point.Questions we are asked
Common questions about measuring response to TACE
When is the first scan after TACE done?
Usually a few weeks after the session, once the swelling has settled and the picture is clearer. Your team sets the exact timing based on your treatment plan. Scanning too early can make a good result look worse than it is.
Is CT or MRI better for checking TACE response?
Both are used. MRI is often clearer after conventional TACE, because the oily contrast left in the tumour can hide small live areas on CT. Which one you have depends on the type of TACE, your kidneys, and what is available. CION arranges either through its diagnostic partners.
What is the difference between mRECIST and RECIST?
RECIST measures the whole tumour. mRECIST measures only the part that still lights up with dye, which is the live part. For liver cancer treated with TACE, mRECIST gives a truer picture because the dead tumour often stays in place.
Does a PET-CT scan show TACE response?
It is not the usual test. Many liver cancers do not show up well on the standard PET-CT, so a contrast CT or MRI remains the main tool. A PET-CT may sometimes be used to look for spread outside the liver.
My report says partial response. Is that good?
It means the live part of the tumour has clearly shrunk, but some of it is still active. That usually supports the TACE plan, and another session aimed at what remains is common. Ask your team what they plan next and why.
What if the scan shows new tumours elsewhere in the liver?
New spots usually count as progression, even if the treated tumour responded well. They may still be treatable with more TACE or another approach. The tumour board looks at the whole liver, not just the tumour treated last time.
How many sessions before they decide TACE is not working?
There is no single number for everyone. Teams look at whether the tumour keeps responding, whether new tumours keep appearing and whether the liver is holding up. The page on how many TACE sessions covers this in more detail.
Can I get a second opinion on my scan report?
Yes. Reading scans after TACE takes experience, and a second look is reasonable before a big change of plan. Bring the images and every previous report. The CION helpline can tell you how to send them for the tumour board to review.
Your Specialists
Meet CION's liver cancer specialists. Bring your scan reports and liver blood tests.
Our medical and surgical oncologists plan liver cancer care together, weighing the tumour and how well your liver works before choosing surgery, a liver-directed procedure or medicines.
Medical Oncologist
Dr. C. Raghavendra Reddy
MBBS(Gold Medal), DNB(General Medicine), DM(Medical Oncology)(Gold Medal)
Medical Oncologist
Dr. Bharati Devi Gorantla
MBBS, MD(General Medicine), DM(Medical Oncology)(Adyar,Chennai), ECMO, MRCP SCE(UK)
Medical Oncologist
Dr. Owais Mohammed
MBBS, MD (General Medicine), DrNB (Medical Oncology), ECMO, MRCP SCE (Medical Oncology) (UK)
Medical Oncologist
Medical Oncologist
Surgical Oncologist
Dr. Muralidhar Muddusetty
MBBS (AIIMS), MS (Surgery) (AIIMS), DNB (Surgical Oncology), MRCS (Edinburgh)
Surgical Oncologist
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Sources
- American Cancer Society — Embolization Therapy for Liver Cancer
- American College of Radiology — ACR Liver Imaging Reporting & Data System (LI-RADS®)
- American Cancer Society — After Liver Cancer Treatment
- NHS — MRI scan
This page is general information, not a prescription. Do not change or stop any treatment based on what you read here. If anything is worrying you, contact your own treating team — or call our helpline and we will help you reach the right specialist.
Keep reading
Related pages
When TACE stops workingWhat happens if the scans keep showing progressionHow many TACE sessions will I need?How response decides whether another session followsAFP after treatmentReading the blood test that sits beside the scanSecond opinions on liver imagingWhen a second read of the scan is worth asking for
Talk to us
Not sure what your scan after TACE is saying?
Share your images and reports, and the tumour board can review them and explain what they show and what usually comes next. One helpline serves every CION centre.