Therapeutic response assessment of RFA for HCC: Contrast-enhanced US, CT and MRI

被引:67
作者
Minami, Yasunori [1 ]
Nishida, Naoshi [1 ]
Kudo, Masatoshi [1 ]
机构
[1] Kinki Univ, Fac Med, Dept Gastroenterol & Hepatol, Osaka 5898511, Japan
基金
日本学术振兴会;
关键词
Hepatocellular carcinoma; Micrometastasis; Microvascular invasion; Radiofrequency ablation; Safety margin; PERCUTANEOUS-ETHANOL-INJECTION; SMALL HEPATOCELLULAR-CARCINOMA; TRANSCATHETER ARTERIAL CHEMOEMBOLIZATION; RANDOMIZED CONTROLLED-TRIAL; RADIOFREQUENCY ABLATION THERAPY; MICROWAVE COAGULATION THERAPY; RADIO-FREQUENCY ABLATION; ACETIC-ACID INJECTION; RISK-FACTORS; RECURRENCE;
D O I
10.3748/wjg.v20.i15.4160
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Radiofrequency ablation (RFA) is commonly applied for the treatment of hepatocellular carcinoma (HCC) because of the facile procedure, and the safety and effectiveness for the treatment of this type of tumor. On the other hand, it is believed that HCC cells should spread predominantly through the blood flow of the portal vein, which could lead to the formation of intrahepatic micrometastases. Therefore, monitoring tumor response after the treatment is quite important and accurate assessment of treatment response is critical to obtain the most favorable outcome after the RFA. Indeed, several reports suggested that even small HCCs of <= 3 cm in diameter might carry intrahepatic micrometastases and/or microvascular invasion. From this point of view, for preventing local recurrences, RFA should be performed ablating a main tumor as well as its surrounding non-tumorous liver tissue where micrometastases and microvascular invasion might exist. Recent advancement of imaging modalities such as contrast-enhanced ultrasonic, computed tomography, and magnetic resonance imaging are playing an important role on assessing the therapeutic effects of RFA. The local recurrence rate tends to be low in HCC patients who were proven to have adequate ablation margin after RFA; namely, not only disappearance of vascular enhancement of main tumor, but also an adequate ablation margin. Therefore, contrast enhancement gives important findings for the diagnosis of recurrent HCCs on each imaging. However, hyperemia of non-tumorous liver surrounding the ablated lesion, which could be attributed to an inflammation after RFA, may well obscure the findings of local recurrence of HCCs after RFA. Therefore, we need to carefully address to these imaging findings given the fact that diagnostic difficulties of local recurrence of HCC. Here, we give an overview of the current status of the imaging assessment of HCC response to RFA. (C) 2014 Baishideng Publishing Group Co., Limited. All rights reserved.
引用
收藏
页码:4160 / 4166
页数:7
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