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AJR 2001; 177:381-387
© American Roentgen Ray Society


Tumor Recurrence After Radiofrequency Thermal Ablation of Hepatic Tumors

Spectrum of Findings on Dual-Phase Contrast-Enhanced CT

Shailendra Chopra1, Gerald D. Dodd, III1, Kedar N. Chintapalli1, John R. Leyendecker1, Okkes I. Karahan1,2 and Hyunchul Rhim1,3

1 Department of Radiology, Mail Code 7800, University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Dr.,, San Antonio TX 78229.
2 Present address: Department of Radiology, University of Erciyes, Kayseri, Turkey.
3 Present address: Department of Radiology, Hanyang University Hospital, Seoul, 133-792, Korea.

OBJECTIVE. We conducted this study to determine the spectrum of CT findings of tumor recurrence after radiofrequency ablation of primary and secondary malignant hepatic tumors.

MATERIALS AND METHODS. Twenty-five patients, 10 with hepatocellular carcinoma (HCC) and 15 patients with metastases who developed tumor recurrence after radiofrequency ablation of hepatic neoplasms, formed the study population. Three observers reviewed the CT scans of these patients and evaluated the location (local intrahepatic, remote intrahepatic, or extrahepatic) of all recurrent lesions and the morphology and enhancement characteristics of local intrahepatic recurrences.

RESULTS. Local intrahepatic recurrences were seen in nine patients (90%) and 11 patients (73%); remote intrahepatic recurrences, in five patients (50%) and seven patients (45%); and extrahepatic recurrences, in zero and six patients (40%) with recurrent HCC and recurrent metastases, respectively. Of the 12 nodules of local intrahepatic recurrences in HCC and the 24 in metastases, the patterns of local intrahepatic recurrences were of nodular, halo, and gross enlargement types in eight (67%) and nine (38%), four (33%) and six (38%), and zero and nine (37%) nodules in HCC and hepatic metastases, respectively. The number of local intrahepatic recurrent lesions enhancing in the arterial phase was significantly greater in HCC.

CONCLUSION. Tumor recurrences occurred at intra- and extrahepatic sites after radiofrequency ablation of hepatic neoplasms. The local intrahepatic recurrences appeared in three patterns: nodular, halo, or gross enlargement. The sites of recurrence and the morphologic patterns of local intrahepatic tumor recurrence differed between primary and secondary hepatic neoplasms.


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