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Local Tumor Progression After Radiofrequency Ablation of Liver Tumors: Analysis of Morphologic Pattern and Site of Recurrence

Shiu Kong Kei1,2, Hyunchul Rhim1, Dongil Choi1, Won Jae Lee1, Hyo K. Lim1 and Young-sun Kim1

1 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.
2 Present address: Department of Diagnostic Radiology, Tuen Mun Hospital, Tuen Mun, New Territories, Hong Kong.


Figure 1
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Fig. 1 Diagram shows classification of morphologic pattern of local tumor progression after radiofrequency ablation of hepatic tumors.

 

Figure 2
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Fig. 2 47-year-old man after radiofrequency ablation for hepatocellular carcinoma. Arterial phase follow-up CT scan at 7 months after radiofrequency ablation shows extrazonal peripheral nodular type of local tumor progression (arrows).

 

Figure 3
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Fig. 3A 52-year-old man after radiofrequency ablation for hepatocellular carcinoma. Immediate follow-up CT scan shows hypoenhancing ablation zone (arrow). Artificial ascites was infused.

 

Figure 4
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Fig. 3B 52-year-old man after radiofrequency ablation for hepatocellular carcinoma. Arterial phase follow-up CT scan obtained 1 month after radiofrequency ablation shows intrazonal crescentic local tumor progression (arrow).

 

Figure 5
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Fig. 4A 44-year-old man after radiofrequency ablation for hepatic metastases from colon cancer. Portal phase follow-up CT scan obtained immediately after radiofrequency ablation shows hypoenhancing ablation zone without residual tumor. Arrow indicates ablation zone.

 

Figure 6
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Fig. 4B 44-year-old man after radiofrequency ablation for hepatic metastases from colon cancer. Portal phase follow-up CT scan obtained 8 months after radiofrequency ablation shows intrazonal gross enlargement type of local tumor progression (arrow).

 

Figure 7
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Fig. 5 72-year-old man after radiofrequency ablation for liver metastases from colon cancer. Portal phase follow-up CT scan obtained 3 months after radiofrequency ablation shows extrazonal crescentic type of local tumor progression (arrow).

 

Figure 8
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Fig. 6A 64-year-old man with hepatocellular carcinoma; concordant case with insufficient ablative margin. Arterial phase CT scan obtained before radiofrequency ablation shows ovoid hyperattenuating mass in right lobe of liver (arrow).

 

Figure 9
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Fig. 6B 64-year-old man with hepatocellular carcinoma; concordant case with insufficient ablative margin. Arterial phase CT scan obtained immediately after radiofrequency ablation shows nonenhancing ablation zone covering index tumor. However, ablative margin over index tumor posteriorly (arrow) is insufficient.

 

Figure 10
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Fig. 6C 64-year-old man with hepatocellular carcinoma; concordant case with insufficient ablative margin. Arterial phase follow-up CT scan obtained 4 months after radiofrequency ablation shows extrazonal peripheral nodular type of local tumor progression at exact site of insufficient ablative margin (arrow).

 

Figure 11
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Fig. 7 64-year-old man with hepatocellular carcinoma after radiofrequency ablation; disconcordant case with contiguous vessel but concordant case with liver capsule. Arterial phase CT scan obtained 1 month after radiofrequency ablation shows extrazonal peripheral nodular type of local tumor progression (arrow) located at different site of contiguous vessel but located at subcapsular region.

 

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