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Growth Rate of New Hepatocellular Carcinoma After Percutaneous Radiofrequency Ablation: Evaluation with Multiphase CT

Yulri Park1, Dongil Choi, Hyo K. Lim, Hyunchul Rhim, Young-sun Kim, Seong Hyun Kim and Won Jae Lee

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, Republic of Korea.


Figure 1
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  		Fig. 1 —Flow diagram of study population. HCC = hepatocellular carcinoma, TACE = transcatheter arterial chemoembolization.

 

Figure 2
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  		Fig. 2A —Model for summation-of-areas technique. Computer drawing depicts tumor, measured areas, and slice thickness of transverse CT scan. Tumor volume is calculated as tumor volume = slice thickness (ST) x summation of areas (A1, A2,..., and A10) of tumor in each transverse scan.

 

Figure 3
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  		Fig. 2B —Model for summation-of-areas technique. Transverse CT scan shows measured areas are polygonal.

 

Figure 4
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  		Fig. 3A —61-year-old man with new hepatocellular carcinoma after radiofrequency ablation of primary hepatocellular carcinoma. Contrast-enhanced transverse CT scan obtained during hepatic arterial phase 22 months after radiofrequency ablation shows 8-mm enhanced area (arrow) in liver segment VIII.

 

Figure 5
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  		Fig. 3B —61-year-old man with new hepatocellular carcinoma after radiofrequency ablation of primary hepatocellular carcinoma. Transverse equilibrium phase CT scan obtained at same examination as A shows no nodule. Prospective radiologic report did not indicate presence of nodule.

 

Figure 6
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  		Fig. 3C —61-year-old man with new hepatocellular carcinoma after radiofrequency ablation of primary hepatocellular carcinoma. Contrast-enhanced hepatic arterial phase transverse CT scan obtained 25 months after ablation shows 18-mm enhanced tumor (arrow).

 

Figure 7
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  		Fig. 3D —61-year-old man with new hepatocellular carcinoma after radiofrequency ablation of primary hepatocellular carcinoma. Equilibrium phase CT scan shows low-attenuation hepatocellular carcinoma (arrow) with washout enhancement pattern. Patient underwent additional radiofrequency ablation of this tumor.

 

Figure 8
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  		Fig. 4 —Graph shows tumor volume doubling times in relation to baseline size of new hepatocellular carcinoma. Middle lines indicate mean; error bars, 1 SD. Tumor volume doubling times of baseline hepatocellular carcinoma with diameter of 1 cm or less are significantly shorter than those of larger baseline tumors (mean, 55 days vs 88 days; p = 0.024).

 

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