Growth rate of new hepatocellular carcinoma after percutaneous radiofrequency ablation: evaluation with multiphase CT

The purpose of this study was to evaluate with serial follow-up CT examinations the growth rate of new hepatocellular carcinoma (HCC) developing after percutaneous radiofrequency ablation and to determine an appropriate follow-up interval for imaging.

Sixty-two new HCCs appearing after percutaneous radiofrequency ablation in 59 patients who underwent follow-up multiphase CT were retrospectively identified. The volume of the new HCCs at follow-up CT was measured on a PACS monitor with an area measuring tool and summation-of-areas technique. We calculated tumor volume doubling time and tumor diameter doubling time. The growth rate was represented by tumor volume doubling time. We also used stepwise multiple linear regression analysis to evaluate the relation between clinical variables and tumor volume doubling time.

Mean baseline and follow-up tumor volumes were 580 mm(3) (range, 85-13,861 mm(3)) and 2,072 mm(3) (range, 535-35,937 mm(3)). Mean baseline and follow-up tumor diameters were 9.9 mm (range, 5.5-29.8 mm) and 15.0 mm (range, 10.1-40.9 mm). Mean tumor volume and tumor diameter doubling times were 75 days (range, 21-209 days) and 219 days (range, 57-897 days). Volume doubling times of baseline tumors with a diameter of 1 cm or less were significantly shorter than those of the larger baseline tumors (mean, 55 vs 88 days; p = 0.024).

The growth rate of new HCCs after percutaneous radiofrequency ablation was higher than that reported in natural outcome studies of untreated HCCs. The results of our study suggest that a shorter follow-up interval for imaging, 2.5 months (75 days), is appropriate.