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Imaging pre- and post-SIRT was assessed for response to treatment via mRECIST and for the presence of diffusion restriction on DWI. Histological specimens were assessed for complete pathological necrosis (CPN).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Twenty-nine tumours were included from 25 patients; mRECIST complete response (CR) demonstrated moderate reliability (sensitivity 0.92, specificity 0.68) for predicting CPN. Twelve tumours did not have diffusion restriction on pretreatment DWI; following their exclusion, loss of diffusion restriction demonstrated a weak agreement (sensitivity 0.85, specificity 0.80, Cohen\u2019s Kappa 0.197) for prediction of CPN. The combination of mRECIST CR and loss of diffusion restriction was associated with CPN in 100% (6\/6) cases; whilst persistent abnormal diffusion restriction despite mRECIST CR was associated with residual disease in 75% (3\/4) cases.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The combination of mRECIST CR when combined with loss of diffusion restriction appears to predict CPN post SIRT; persistent diffusion restriction despite the findings of mRECIST CR appears to correlate with residual disease.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00261-026-05377-5","type":"journal-article","created":{"date-parts":[[2026,2,9]],"date-time":"2026-02-09T02:33:23Z","timestamp":1770604403000},"page":"3893-3902","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Loss of both diffusion restriction and arterial enhancement can predict complete pathological response following Y-90 selective internal radiation therapy for hepatocellular carcinoma"],"prefix":"10.1007","volume":"51","author":[{"given":"Kah Heng Alexander","family":"Lim","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew Joel","family":"Clifford","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William","family":"Ormiston","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tze Sheng","family":"Khor","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Khanh Quoc Steven","family":"Ngo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alistair","family":"Rowcroft","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lingjun","family":"Mou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luc","family":"Delriviere","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Wallace","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mayank","family":"Bhandari","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammad","family":"Ballal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan","family":"Tibballs","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,2,9]]},"reference":[{"issue":"3","key":"5377_CR1","doi-asserted-by":"publisher","first-page":"604","DOI":"10.1007\/s11605-022-05559-8","volume":"27","author":"A Hamad","year":"2023","unstructured":"Hamad A, Aziz H, Kamel IR, Diaz DA, Pawlik TM (2023) Yttrium-90 Radioembolization: Current Indications and Outcomes. 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