title: Detecting postsurgical recurrent hepatocellular carcinoma with multiphasic helical computed tomography: intrahepatic metastasis or multicentric occurrence?
abstract: OBJECTIVE
  The aim of this study was to assess the computed tomography (CT) patterns of postoperative recurrent hepatocellular carcinoma (HCC).
  
  
  METHODS
  Of 84 patients with histologically proven HCC by hepatectomies, multiphasic helical CT demonstrated 54 HCC lesions of intrahepatic recurrence in 31 (37%) patients. The initial and final appearances of HCC on hepatic arterial phase images were retrospectively determined by the serial CT scans, which were compared with appearances of primary HCC.
  
  
  RESULTS
  The initial appearances of 54 recurrent HCCs were identical to the appearances of primary HCC in 41 (76%) lesions. Serial changes from the initial appearance to the final appearance of recurrent HCC were observed in 10 (42%) of 24 lesions. The 13 discordant lesions and the 10 lesions with altered lesion vascularity in our series implied that at least 43% were of multicentric occurrence.
  
  
  CONCLUSIONS
  More than 40% of postoperative recurrent HCCs show intranodular hemodynamic changes. The incompatibility between CT findings of primary and recurrent HCCs implies that these tumors contain nodules of multicentric occurrence.
authors.affiliation: Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan. ttajima@dr.hosp.kyushu-u.ac.jp
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Tajima
authors.forename: Kengo
authors.initials: K
authors.lastname: Yoshimitsu
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Irie
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Aibe
authors.forename: Kenji
authors.initials: K
authors.lastname: Shinozaki
authors.forename: Akihiro
authors.initials: A
authors.lastname: Nishie
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Honda
authors.forename: Mitsuo
authors.initials: M
authors.lastname: Shimada
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging* / Q000556:secondary / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006498:Hepatectomy; D006499:Hepatic Artery / Q000000981:diagnostic imaging; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods; D008113:Liver Neoplasms / Q000000981:diagnostic imaging* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000145:classification / Q000000981:diagnostic imaging*; D018365:Neoplasm, Residual / Q000000981:diagnostic imaging; D012189:Retrospective Studies; D036542:Tomography, Spiral Computed / Q000379:methods*