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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.



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  		Fig. 1A. —Hepatocellular carcinoma in 61-year-old man. Arterial phase CT scan shows hypervascular mass (arrow) in right lobe of liver. (Reprinted with permission from [31])

 


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  		Fig. 1B. —Hepatocellular carcinoma in 61-year-old man. Arterial phase CT scan obtained 1 day after radiofrequency ablation of mass seen in A shows low-attenuation ablated lesion with peripheral hyperemia (arrow). (Reprinted with permission from [31])

 


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  		Fig. 1C. —Hepatocellular carcinoma in 61-year-old man. Arterial phase CT scan obtained 1 month after radiofrequency ablation shows almost complete resolution of hyperemia (arrow). (Reprinted with permission from [31])

 


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  		Fig. 1D. —Hepatocellular carcinoma in 61-year-old man. Arterial phase CT scan obtained 3 months after radiofrequency ablation shows nodular-type local intrahepatic recurrence seen as hypervascular nodule (arrow) at margin of ablated lesion. (Reprinted with permission from [31])

 


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  		Fig. 1E. —Hepatocellular carcinoma in 61-year-old man. Portal venous phase CT scan obtained immediately after D shows that recurrent nodule (arrow) has become isodense with remainder of liver parenchyma. Nodule is much more difficult to see than in D.

 


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  		Fig. 2A. —Hepatic metastasis from colon cancer in 71-year-old man. Portal venous phase CT scan shows heterogeneous low-attenuation mass (arrow) in right lobe of liver.

 


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  		Fig. 2B. —Hepatic metastasis from colon cancer in 71-year-old man. Portal venous phase CT scan obtained 1 month after radiofrequency ablation of mass seen in A shows low-attenuation ablated lesion (arrow) with no peripheral hyperemia.

 


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  		Fig. 2C. —Hepatic metastasis from colon cancer in 71-year-old man. Portal venous phase CT scan obtained 7 months after radiofrequency ablation shows nodular-type local intrahepatic recurrence seen as low-attenuation nodule (arrow) at margin of ablated lesion.

 


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  		Fig. 3A. —Hepatic metastasis from colon cancer in 56-year-old man. Portal venous phase CT scan shows heterogeneous low-attenuation mass (arrow) in left lobe of liver.

 


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  		Fig. 3B. —Hepatic metastasis from colon cancer in 56-year-old man. Portal venous phase CT scan obtained 1 month after radiofrequency ablation of mass seen in A shows low-attenuation ablated lesion (arrow) with no peripheral hyperemia.

 


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  		Fig. 3C. —Hepatic metastasis from colon cancer in 56-year-old man. Portal venous phase CT scan obtained 3 months after radiofrequency ablation shows halo-type local intrahepatic recurrence seen as rim of subtly increased attenuation (arrow) along margins of ablated lesion. Note margins of lesion are now ill-defined.

 


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  		Fig. 4A. —Hepatic metastasis from pancreatic cancer in 49-year-old man. Portal venous phase CT scan shows heterogeneous low-attenuation mass (arrow) in left lobe of liver.

 


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  		Fig. 4B. —Hepatic metastasis from pancreatic cancer in 49-year-old man. Portal venous phase CT scan obtained 1 day after radiofrequency ablation of mass seen in A shows low-attenuation ablated lesion with no peripheral hyperemia (arrow).

 


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  		Fig. 4C. —Hepatic metastasis from pancreatic cancer in 49-year-old man. Portal venous phase CT scan obtained 2 months after radiofrequency ablation shows gross enlargement—type local intrahepatic recurrence seen as increase in size of ablated lesion (arrow).

 

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