Hepatocellular carcinoma: CT appearance after percutaneous ethanol ablation therapy. Work in progress

Area of Science:

• Hepatobiliary Medicine
• Interventional Radiology
• Oncology

Background:

• Hepatocellular carcinoma (HCC) is a major global health concern.
• Percutaneous ethanol ablation therapy (PEAT) is a minimally invasive treatment option for HCC.
• Accurate assessment of PEAT efficacy is crucial for patient management.

Purpose of the Study:

• To evaluate the utility of immediate post-treatment computed tomography (CT) findings in predicting the success of percutaneous ethanol ablation therapy (PEAT) for hepatocellular carcinoma (HCC).
• To correlate CT imaging features immediately after PEAT with subsequent biopsy results and disease-free status in HCC patients.

Main Methods:

• Nine patients with biopsy-proven HCC underwent PEAT under CT guidance.
• Twenty-five ablation sessions were performed on nine HCC lesions (1.8–6.5 cm).
• Repeat biopsies were conducted on seven lesions 1–2 months post-therapy; CT scans were obtained immediately after ablation.

Main Results:

• Five patients showed post-ablation necrotic areas equal to the target lesion size on CT; four of these had negative biopsies and remained disease-free.
• Patients with CT evidence of limited necrosis were not disease-free.
• Three patients exhibited peripheral nodularity on post-ablation CT; none were disease-free.
• Four patients with no post-ablation peripheral nodularity were disease-free.

Conclusions:

• Immediate post-ablation CT findings of adequate necrosis and absence of peripheral nodularity are highly suggestive of successful PEAT for HCC.
• CT imaging shortly after PEAT can serve as a valuable tool for early prediction of treatment outcomes in hepatocellular carcinoma.
• These imaging criteria may help in guiding further treatment decisions and patient follow-up strategies.