Department of Radiology, University of Palermo, Via Del Carabiniere 32, 90127, Palermo, Italy.
Radiol Med. 2012 Aug;117(5):739-48. doi: 10.1007/s11547-011-0752-z. Epub 2011 Nov 17.
The authors sought to assess the incidence of new foci of hepatocellular carcinoma (HCC) using multidetector computed tomography (MDCT) in patients treated with radiofrequency ablation (RFA).
Two readers retrospectively reviewed by consensus the follow-up MDCT studies of 125 patients (88 men and 37 women; mean age 68 years) with 141 HCCs (size 1-5.2 cm; mean 2.2 cm) treated with RFA. MDCT follow-up was performed at 1 and 3 months and every 6-12 months thereafter. Reviewers assessed: (1) the presence of new HCC foci in the same liver segment or in a different segment; (2) complete or incomplete tumour ablation; (3) tumour progression.
A total of 113 new HCCs (size 0.7-4.8 cm; mean 1.7 cm) were detected in 69/125 (55.2%) patients (mean follow-up 30.38±19.14 months). Of these, 86 (76.1%) new HCCs were multiple (p<0.0001), and 92 (81.4%) occurred in a different segment from that of the treated HCC (p<0.0001). New HCCs were observed in the first 12 months, between 12 and 24 months and after 24 months in 31/69 (44.9%), 24/69 (34.8%) and 14/69 (20.3%) patients, respectively (p=0.175). Mean diseasefree interval was 16.1±16.31 (range 1-52) months. Complete tumour ablation was achieved in 132/141 (93.6%) treated HCCs, and tumour progression occurred in 29/141 (20.6%) cases.
In patients with RFA-treated HCCs, MDCT follow-up revealed a high incidence of new HCCs, even after 1 year of follow-up. The new foci tended to be multiple and located in a liver segment different from that of the previously treated nodules.
作者旨在评估多排螺旋 CT（MDCT）在射频消融（RFA）治疗的患者中用于检测新的肝细胞癌（HCC）病灶的发生率。
两位读者通过共识回顾性地分析了 125 例（88 名男性和 37 名女性；平均年龄 68 岁）141 个 HCC（大小 1-5.2cm；平均 2.2cm）经 RFA 治疗患者的随访 MDCT 研究。MDCT 随访在 1 个月和 3 个月进行，此后每 6-12 个月进行一次。评估者评估了：（1）同一肝段或不同肝段出现新的 HCC 病灶；（2）完全或不完全肿瘤消融；（3）肿瘤进展。
在 69/125（55.2%）例患者（平均随访 30.38±19.14 个月）中发现了 113 个新的 HCC（大小 0.7-4.8cm；平均 1.7cm）。其中，86 个（76.1%）为多发 HCC（p<0.0001），且 92 个（81.4%）位于与治疗 HCC 不同的肝段（p<0.0001）。新 HCC 分别在 69 例患者的第 12 个月、12-24 个月和 24 个月后观察到，分别为 31 例（44.9%）、24 例（34.8%）和 14 例（20.3%）（p=0.175）。平均无疾病间隔为 16.1±16.31（范围 1-52）个月。141 个治疗 HCC 中 132 个（93.6%）达到完全肿瘤消融，29 个（20.6%）发生肿瘤进展。
在 RFA 治疗的 HCC 患者中，MDCT 随访显示新 HCC 的发生率很高，即使在随访 1 年后也是如此。新病灶往往是多发的，位于与之前治疗结节不同的肝段。
