Detecting postsurgical recurrent hepatocellular carcinoma with multiphasic helical computed tomography: intrahepatic metastasis or multicentric occurrence?
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.
Tajima
Tsuyoshi
T
Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan. ttajima@dr.hosp.kyushu-u.ac.jp
Yoshimitsu
Kengo
K
Irie
Hiroyuki
H
Aibe
Hitoshi
H
Shinozaki
Kenji
K
Nishie
Akihiro
A
Honda
Hiroshi
H
Shimada
Mitsuo
M
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*