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Needle Tract Implantation After Sonographically Guided Percutaneous Biopsy of Hepatocellular Carcinoma: Evaluation of Doubling Time, Frequency, and Features on CT

¹ All authors: Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-dong, Kangnam-ku, Seoul 135-710, South Korea.

View larger version (111K): [in a new window]   Fig. 1A —50-year-old man with small nodule in subcutaneous fat layer. CT image obtained 116 days after sonographically guided percutaneous biopsy of hepatocellular carcinoma shows small nodule (arrow) just left to midline.

View larger version (115K): [in a new window]   Fig. 1B —50-year-old man with small nodule in subcutaneous fat layer. CT image obtained 201 days after sonographically guided percutaneous biopsy shows nodule (arrow) has grown rapidly, yielding shortest doubling time of 22 days.

View larger version (96K): [in a new window]   Fig. 2A —Implanted hepatocellular carcinoma (HCC). CT image in 47-year-old man shows implanted HCC (arrows) of linear configuration in abdominal wall of epigastrium.

View larger version (89K): [in a new window]   Fig. 2B —Implanted hepatocellular carcinoma (HCC). CT image in 65-year-old woman shows implanted HCC (arrows) of linear configuration in subcutaneous fat layer and intercostal muscle layer of right lateral chest wall.

View larger version (96K): [in a new window]   Fig. 3A —45-year-old woman after biopsy of hepatocellular carcinoma (HCC). Adjacent CT images obtained after sonographically guided percutaneous biopsy of HCC show four small implanted tumors (arrows) of round or oval configuration in linear arrangement extending from intraperitoneum to subcutaneous fat layer of right lateral chest wall through needle tract.

View larger version (102K): [in a new window]   Fig. 3B —45-year-old woman after biopsy of hepatocellular carcinoma (HCC). Adjacent CT images obtained after sonographically guided percutaneous biopsy of HCC show four small implanted tumors (arrows) of round or oval configuration in linear arrangement extending from intraperitoneum to subcutaneous fat layer of right lateral chest wall through needle tract.

View larger version (89K): [in a new window]   Fig. 4A —65-year-old man with implanted hepatocellular carcinomas (HCCs). Unenhanced (A), arterial (B), portal venous (C), and equilibrium (D) phase images show two oval implanted HCCs (arrows) in subcutaneous fat layer and intercostal muscle layer. HCCs show arterial enhancement and delayed washout pattern. Note that HCCs are not hypodense to adjacent intercostal muscles on equilibrium phase image (D).

View larger version (101K): [in a new window]   Fig. 4B —65-year-old man with implanted hepatocellular carcinomas (HCCs). Unenhanced (A), arterial (B), portal venous (C), and equilibrium (D) phase images show two oval implanted HCCs (arrows) in subcutaneous fat layer and intercostal muscle layer. HCCs show arterial enhancement and delayed washout pattern. Note that HCCs are not hypodense to adjacent intercostal muscles on equilibrium phase image (D).

View larger version (106K): [in a new window]   Fig. 4C —65-year-old man with implanted hepatocellular carcinomas (HCCs). Unenhanced (A), arterial (B), portal venous (C), and equilibrium (D) phase images show two oval implanted HCCs (arrows) in subcutaneous fat layer and intercostal muscle layer. HCCs show arterial enhancement and delayed washout pattern. Note that HCCs are not hypodense to adjacent intercostal muscles on equilibrium phase image (D).

View larger version (103K): [in a new window]   Fig. 4D —65-year-old man with implanted hepatocellular carcinomas (HCCs). Unenhanced (A), arterial (B), portal venous (C), and equilibrium (D) phase images show two oval implanted HCCs (arrows) in subcutaneous fat layer and intercostal muscle layer. HCCs show arterial enhancement and delayed washout pattern. Note that HCCs are not hypodense to adjacent intercostal muscles on equilibrium phase image (D).

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