Altered findings of hepatic arteriography after radiofrequency ablation of hepatocellular carcinoma: comparison of pre-ablation and post-ablation angiograms.
OBJECTIVE
To evaluate the altered findings of hepatic arteriography after radiofrequency (RF) ablation of hepatocellular carcinoma which can potentially influence subsequent transcatheter arterial chemoembolization.


METHODS
Hepatic arteriograms of 26 index hepatocellular carcinomas in 24 patients treated only by RF ablation (M:F = 22:2, mean age 55 years), in which hepatic arteriography was performed before and after RF ablation, were retrospectively compared for the altered findings.


RESULTS
The altered findings of hepatic arteriography after RF ablation of the hepatocellular carcinoma were arterio-portal shunt (n = 3), periablational enhancement (n = 5), varied caliber of the feeding artery to the index tumor (n = 12) among which eight decreased, and occlusion of an adjacent arterial branch (n = 8). Residual unablated or locally progressed tumor was not detected in post-RF ablation arteriography (n = 5) due to the arterio-portal shunt (n = 2) or the periablational enhancement (n = 3). The possibility of not detecting the residual unablated or locally progressed tumor was higher within 24 weeks after RF ablation (Mann-Whitney test, P = 0.041).


CONCLUSIONS
The findings of hepatic arteriography are altered after RF ablation, and the altered findings may increase the difficulty in performing super-selective transcatheter arterial chemoembolization due to undetected tumor staining, decreased caliber, or occlusion of the feeding artery.
Kim
Byung Moon
BM
Department of Diagnostic Radiology, Kangbuk Samsung Hospital, Seoul, Korea.
Cho
Jae-Hyun
JH
Won
Je Hwan
JH
Lee
Do Yun
DY
Lee
Jong Tae
JT
Kim
Hyun Cheol
HC
Park
Sung Il
SI
D000328:Adult; D000368:Aged; D000792:Angiography; D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging / Q000601:surgery*; D017115:Catheter Ablation; D005260:Female; D006801:Humans; D008099:Liver / Q000098:blood supply*; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D008875:Middle Aged