Orlando Catalano MD, Abstract Co-Author: Nothing to Disclose

Pietro Paolo Saturnino MD, Presenter: Nothing to Disclose

Paolo Vallone MD, Abstract Co-Author: Nothing to Disclose

Francesco Izzo MD, Abstract Co-Author: Nothing to Disclose

Vittoria Nunziata, Abstract Co-Author: Nothing to Disclose

Antonella Petrillo MD, Abstract Co-Author: Nothing to Disclose

HCC patients treated with percutaneous ablation require close follow-up for detecting tumour recurrence. We illustrate our single-centre experience on using CEUS as a follow-up tool alternated with CT.

In a 7-year period there were 588 patients with 1-3 HCCs treated with radiofrequency ablation (alone or combined with ethanol injection). Patients with completely ablated tumours at 1-mo. CT were followed-up serially, using alternated CEUS (one sulphur hexafluoride-based microbubbles injection per lobe) and CT every 3 months. The following patterns of recurrence were considered: A, enhancing tissue within the lesion; B, enhancing tissue adherent to the lesion; C, enhancing tissue within the same liver segment of the treated nodule; D, enhancing tissue within a different segment (progression). Patients with positive CEUS underwent confirmatory CT (standard reference).

Median follow-up was 29 months. There were 221 recurrences. Three pattern A recurrences (2 detected by CEUS and 1 by CT), 86 pattern B recurrences (44 detected by CEUS and 42 by CT), 70 pattern C recurrences (32 detected by CEUS and 38 by CT), and 62 pattern D recurrences (23 detected by CEUS and 39 by CT). CT detected additional nodules in 16/101 patients with positive CEUS.

CEUS is more sensitive than US in detecting HCC recurrence after percutaneous ablation and is as effective as CT in detecting HCC relapse within the same segment of the ablated nodule. Since 72% recurrences develop in the same segment of the necrotic nodule, CEUS proves to be effective despite the less comprehensive liver survey compared to CT.

Patients with ablated HCC nodule are at high risk of recurrence and require a close, long-term monitorization. Including CEUS in patient follow-up may allow decreasing the number of CT examinations.

Catalano, O, Saturnino, P, Vallone, P, Izzo, F, Nunziata, V, Petrillo, A, Contrast-enhanced Sonography (CEUS) in the Follow-up of Patients with Percutaneously-ablated Hepatocellular Carcinoma (HCC).  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14011701.html