Surveillance of HCC Patients after Liver RFA : Role of MRI with Hepatospecific Contrast versus Three-Phase CT Scan—Experience of High Volume Oncologic Institute

Abstract EN

Purpose.

To compare the diagnostic accuracy of hepatospecific contrast-enhanced MRI versus triple-phase CT scan after radiofrequency ablation (RFA) in hepatocellular carcinoma (HCC) patients.

Methods.

Thirty-four consecutive HCC patients (42 hepatic nodules) were treated with percutaneous RFA and underwent MR and CT scans.

All patients were enrolled in a research protocol that included CT with iodized contrast medium injection and MR with hepatospecific contrast medium injection.

All patients were restaged within four weeks and at 3 months from ablation.

The images were reviewed by four different radiologists to evaluate tumor necrosis, residual or recurrence disease, and evidence of new foci.

Results.

Thirty-two nodules were necrotic after treatment; 10 showed residual disease.

Six new HCCs were identified.

At first month followup CT has identified 34 necrotic lesions and 8 residual diseases; no new foci were recognized.

At MRI instead, 32 complete necrotic lesions were identified, 10 lesions showed residual disease, and 2 new HCCs were found.

At three months, CT demonstrated 33 completely necrotic lesions, 9 residual diseases, and 2 new HCCs.

MR showed 31 complete necrotic lesions, 11 cases of residual disease, and 6 new HCCs.

Conclusions.

Hepatospecific contrast-enhanced MRI is more effective than multiphase CT in assessment of HCC treated with RFA.