Hepatocellular Carcinoma Treated with Radio-frequency Ablation: Spectrum of Imaging Findings

Seung Kwon Kim, Hyo Keun Lim, Young Han Kim, Won Jae Lee, Soon Jin Lee, Seung Hoon Kim, Jae Hoon Lim, Soo Ah Kim

Research output: Contribution to journalReview article

98 Scopus citations

Abstract

Contrast material-enhanced Doppler or gray-scale harmonic ultrasonography (US) may help determine the completeness or long-term therapeutic efficacy of radio-frequency (RF) ablation of hepatocellular carcinoma (HCC). Successfully treated HCC is devoid of vascularity at color or power Doppler US. When the tumor is not completely treated, residual viable tumor can be detected. These contrast-enhanced US techniques may also help identify residual tumor when performed during repeat RF ablation, when accurate localization of viable tumor is needed. To date, contrast-enhanced computed tomography (CT) has been the most widely used imaging modality in the evaluation of therapeutic response after RF ablation of HCC. At follow-up CT, successfully ablated lesions appear as low-attenuation areas with no foci of contrast enhancement either within or at the periphery of the treated lesion, whereas any foci of enhancement indicate residual or recurrent tumor. Reactive hyperemia in tissue surrounding the ablated lesion, iatrogenic arterioportal shunting, and small intralesional air pockets are frequently seen at immediate follow-up CT. Gadolinium-enhanced dynamic magnetic resonance imaging is also useful in assessing therapeutic response following RF ablation of HCC, particularly when CT findings are inconclusive. Familiarity with these imaging findings is helpful in this setting.

Original languageEnglish
Pages (from-to)107-121
Number of pages15
JournalRadiographics
Volume23
Issue number1
DOIs
StatePublished - Jan 1 2003
Externally publishedYes

Keywords

  • Liver neoplasms, 76.323
  • Liver neoplasms, CT, 76.1211
  • Liver neoplasms, MR, 76.1214
  • Liver neoplasms, US, 76.1298
  • Liver neoplasms, therapy
  • Radiofrequency (RF) ablation, 761.1269

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  • Cite this

    Kim, S. K., Lim, H. K., Kim, Y. H., Lee, W. J., Lee, S. J., Kim, S. H., Lim, J. H., & Kim, S. A. (2003). Hepatocellular Carcinoma Treated with Radio-frequency Ablation: Spectrum of Imaging Findings. Radiographics, 23(1), 107-121. https://doi.org/10.1148/rg.231025055