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Imaging findings after liver resection by using radiofrequency parenchymal coagulation devices: initial experiences
John P McGahan1, Vijay P Khatri
1Departments of Radiology and Surgery, University of California Davis Medical Center, 4501 X St, Suite 3010, Sacramento, CA 95817, USA.
Radiology
|May 20, 2008
Summary
Radiofrequency devices used in liver surgery create a hypodense line on CT scans and hypermetabolic activity on PET scans, which can mimic tumor recurrence. Careful interpretation is needed to avoid misdiagnosis of post-hepatectomy changes.
Area of Science:
- Radiology
- Surgical Oncology
- Hepatobiliary Surgery
Background:
- Hepatic resections are common for liver tumors.
- Radiofrequency devices are used for parenchymal coagulation during liver surgery.
- Interpreting post-surgical imaging can be challenging.
Purpose of the Study:
- To evaluate imaging features at surgical sites after hepatic resection.
- To identify potential interpretation pitfalls when using InLine and TissueLink devices.
- To assess findings related to parenchymal coagulation prior to transection.
Main Methods:
- Retrospective review of 26 patients undergoing hepatic resection.
- Analysis of CT, PET, MRI, and ultrasound images.
- Comparison of radiologist review with initial reports.
Main Results:
- A hypodense line was seen in 33 of 35 CT scans.
- This demarcation was misinterpreted as recurrence in 8 cases.
- PET scans showed hypermetabolic activity mimicking recurrence.
Conclusions:
- InLine and TissueLink devices cause a linear hypodense demarcation post-hepatectomy.
- This finding exhibits symmetrical rimlike hypermetabolic activity on PET scans.
- Awareness of these imaging features is crucial to avoid misinterpreting them as recurrence.
