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Radiofrequency Ablation of Hepatocellular Carcinoma in Patients with Decompensated Cirrhosis: Evaluation of Therapeutic Efficacy and Safety

Young Kon Kim1, Chong Soo Kim1, Gyong Ho Chung1, Young Min Han1, Sang Yong Lee1, Gong Yong Jin1 and Jeong Min Lee2

1 Department of Diagnostic Radiology, Chonbuk National University Hospital and Medical School, Jeonju, South Korea.
2 Department of Radiology and Institute of Radiation Medicine, Seoul National University Hospital, Seoul, Korea, 28, Yongon-dong, Chongno-gu, Seoul 110-744, South Korea.


Figure 1
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  		Fig. 1A —57-year-old man with hepatocellular carcinoma complicating Child C liver cirrhosis. Superparamagnetic iron oxide-enhanced T2-weighted turbo spin-echo image shows high-signal-intensity lesion (arrow).

 

Figure 2
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  		Fig. 1B —57-year-old man with hepatocellular carcinoma complicating Child C liver cirrhosis. Superparamagnetic iron oxide-enhanced T2-weighted turbo spin-echo image obtained 8 months after first radiofrequency ablation shows small area of high-signal-intensity marginal recurrence (arrow).

 

Figure 3
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  		Fig. 1C —57-year-old man with hepatocellular carcinoma complicating Child C liver cirrhosis. On unenhanced CT scan obtained during radiofrequency ablation, 17-gauge single electrode with 3.0-cm exposed tip is seen within tumor.

 

Figure 4
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  		Fig. 1D —57-year-old man with hepatocellular carcinoma complicating Child C liver cirrhosis. Contrast-enhanced CT scan obtained immediately after second radiofrequency ablation shows completely nonenhancing area (arrow) at site of treated nodule.

 

Figure 5
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  		Fig. 1E —57-year-old man with hepatocellular carcinoma complicating Child C liver cirrhosis. Contrast-enhanced CT scan obtained 12 months after radiofrequency ablation shows decrease in size of nonenhancing area (arrow), without marginal recurrence.

 

Figure 6
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  		Fig. 2A —54-year-old man with hepatocellular carcinoma complicating Child C liver cirrhosis. Contrast-enhanced CT scan obtained before radiofrequency ablation shows slightly enhancing hepatocellular carcinoma (arrow) in liver segment V. Small amount of perihepatic ascites is seen.

 

Figure 7
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  		Fig. 2B —54-year-old man with hepatocellular carcinoma complicating Child C liver cirrhosis. On unenhanced CT scan obtained during radiofrequency ablation, 17-gauge single electrode with 3.0-cm exposed tip is seen within tumor.

 

Figure 8
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  		Fig. 2C —54-year-old man with hepatocellular carcinoma complicating Child C liver cirrhosis. Contrast-enhanced CT scan obtained immediately after radiofrequency ablation shows completely unenhanced area (arrow) at site of treated nodule.

 

Figure 9
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  		Fig. 2D —54-year-old man with hepatocellular carcinoma complicating Child C liver cirrhosis. Contrast-enhanced CT scan obtained 12 months after radiofrequency ablation shows decrease in size of nonenhancing area (arrow), without marginal recurrence. Perihepatic ascites is increased, compared with A.

 

Figure 10
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  		Fig. 3A —60-year-old man with hepatocellular carcinoma complicating Child C liver cirrhosis. Contrast-enhanced CT scan obtained before radiofrequency ablation shows slightly enhancing hepatocellular carcinoma (large arrow) in liver segment V. Small amount of perihepatic ascites and gallbladder stones (small striped arrow) are seen.

 

Figure 11
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  		Fig. 3B —60-year-old man with hepatocellular carcinoma complicating Child C liver cirrhosis. Contrast-enhanced CT scan obtained immediately after radiofrequency ablation shows completely nonenhancing area (arrow) at site of treated nodule.

 

Figure 12
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  		Fig. 3C —60-year-old man with hepatocellular carcinoma complicating Child C liver cirrhosis. Contrast-enhanced CT scan obtained 25 months after radiofrequency ablation shows decrease in size of nonenhancing area (arrow), without marginal recurrence. Perihepatic ascites and size of gallbladder stones are increased, compared with A. Atrophic liver changes have also progressed from those shown in A.

 

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