Simple　Summary　Transarterial　chemoembolization　is　the　main　therapy　for　patients　with　intermediate-stage　hepatocellular　carcinoma;　it　has　demonstrated　efficacy　and　survival　benefits.　However,　treatment　success　cannot　always　be　achieved　after　one　treatment　session.　Using　a　quantitative　3D　tumor-response　assessment,　we　showed　that　a　second　transarterial　chemoembolization　in　patients　who　initially　do　not　respond　to　therapy　results　in　both　objective　tumor　response　and　survival　benefits.　Thus,　at　least　two　sessions　should　be　performed　before　TACE　is　abandoned　and　alternative　treatments　are　considered.　Objectives:　The　purpose　of　this　study　was　to　assess　treatment　responses　and　evaluate　survival　outcomes　between　responders　and　non-responders　after　each　transarterial　chemoembolization　(TACE)　session　using　the　3D　quantitative　criteria　of　the　European　Association　for　the　Study　of　the　Liver　(qEASL)　in　hepatocellular　carcinoma　(HCC)　patients.　Methods:　A　total　of　94　consecutive　patients　who　underwent　MR　imaging　before　and　after　TACE　were　retrospectively　included.　Volumetric　tumor　enhancement　(qEASL)　was　expressed　in　cubic　centimeters　(cm(3)).　The　Kaplan-Meier　method　with　the　log-rank　test　was　used　to　calculate　the　overall　survival　(OS)　for　the　non-/responders.　Results:　In　total,　28　(29.8%)　patients　showed　a　response　after　the　first　TACE.　These　responders　demonstrated　a　clear　trend　toward　longer　OS　compared　with　the　non-responders　(36.7　vs.　21.5　months,　p　=　0.071).　Of　the　43　initial　non-responders　who　underwent　a　second　TACE　within　3　months　and　had　complete　follow-up　imaging,　15/43　(34.9%)　achieved　a　response,　and　their　median　OS　was　significantly　longer　than　that　of　the　28　non-responders　to　the　second　TACE　(47.8　vs.　13.6　months,　p　=　0.01).　Furthermore,　there　was　no　significant　difference　in　OS　between　the　28　patients　who　achieved　a　response　after　the　first　TACE　and　the　15　initial　non-responders　who　achieved　a　response　after　the　second　TACE　(36.7　vs.　47.8　months,　p　=　0.701).　The　difference　in　OS　between　the　responders　and　non-responders　after　the　third　TACE　was　not　significant　(11.4　months　vs.　13.5　months,　p　=　0.986).　Conclusion:　Our　study　quantitatively　demonstrated　that　a　second　TACE　can　be　beneficial　in　terms　of　tumor　response　and　survival　for　HCC　patients　who　do　not　initially　respond　to　TACE.