title: Incidence of new foci of hepatocellular carcinoma after radiofrequency ablation: role of multidetector CT.
abstract: OBJECTIVE
  The authors sought to assess the incidence of new foci of hepatocellular carcinoma (HCC) using multidetector computed tomography (MDCT) in patients treated with radiofrequency ablation (RFA).
  
  
  METHODS
  Two readers retrospectively reviewed by consensus the follow-up MDCT studies of 125 patients (88 men and 37 women; mean age 68 years) with 141 HCCs (size 1-5.2 cm; mean 2.2 cm) treated with RFA. MDCT follow-up was performed at 1 and 3 months and every 6-12 months thereafter. Reviewers assessed: (1) the presence of new HCC foci in the same liver segment or in a different segment; (2) complete or incomplete tumour ablation; (3) tumour progression.
  
  
  RESULTS
  A total of 113 new HCCs (size 0.7-4.8 cm; mean 1.7 cm) were detected in 69/125 (55.2%) patients (mean follow-up 30.38±19.14 months). Of these, 86 (76.1%) new HCCs were multiple (p<0.0001), and 92 (81.4%) occurred in a different segment from that of the treated HCC (p<0.0001). New HCCs were observed in the first 12 months, between 12 and 24 months and after 24 months in 31/69 (44.9%), 24/69 (34.8%) and 14/69 (20.3%) patients, respectively (p=0.175). Mean diseasefree interval was 16.1±16.31 (range 1-52) months. Complete tumour ablation was achieved in 132/141 (93.6%) treated HCCs, and tumour progression occurred in 29/141 (20.6%) cases.
  
  
  CONCLUSIONS
  In patients with RFA-treated HCCs, MDCT follow-up revealed a high incidence of new HCCs, even after 1 year of follow-up. The new foci tended to be multiple and located in a liver segment different from that of the previously treated nodules.
authors.affiliation: Department of Radiology, University of Palermo, Via Del Carabiniere 32, 90127, Palermo, Italy. tv.bartolotta@unipa.it
authors.forename: T V
authors.initials: TV
authors.lastname: Bartolotta
authors.forename: A
authors.initials: A
authors.lastname: Taibbi
authors.forename: D
authors.initials: D
authors.lastname: Matranga
authors.forename: L
authors.initials: L
authors.lastname: Sandonato
authors.forename: S
authors.initials: S
authors.lastname: Asta
authors.forename: M
authors.initials: M
authors.lastname: Midiri
authors.forename: R
authors.initials: R
authors.lastname: Lagalla
mesh_terms: D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000473:pathology / Q000601:surgery*; D017115:Catheter Ablation; D016009:Chi-Square Distribution; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008113:Liver Neoplasms / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography; D009364:Neoplasm Recurrence, Local; D012189:Retrospective Studies; D016896:Treatment Outcome
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