Optimal Imaging Surveillance Schedules after Liver-Directed Therapy for Hepatocellular Carcinoma

Boas, F. Edward; Do, Bao; Louie, John D.; Kothary, Nishita; Hwang, Gloria L.; Kuo, William T.; Hovsepian, David M.; Kantrowitz, Mark; Sze, Daniel Y.

doi:10.1016/j.jvir.2014.09.013

Cited by 54 publications

(34 citation statements)

References 9 publications

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“…Initial follow up was performed with multiphase CT or MRI post ablation (11). Institutional guidelines dictated that initial follow up imaging be obtained at 1 month post procedure.…”

Section: Methodsmentioning

confidence: 99%

Radiofrequency vs Microwave Ablation After Neoadjuvant Transarterial Bland and Drug-Eluting Microsphere Chembolization for the Treatment of Hepatocellular Carcinoma

Thornton

Cabrera

Kapp

et al. 2017

Current Problems in Diagnostic Radiology

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Aim To retrospectively compare the initial response, local recurrence, and complication rates of radiofrequency ablation (RFA) vs microwave ablation (MWA) when combined with neoadjuvant bland transarterial embolization (TAE) or drug eluting microsphere chemoembolization (TACE) for the treatment of hepatocellular carcinoma (HCC). Methods A total of 35 subjects with BCLC very early and early stage HCC (range 1.2 – 4.1 cm) underwent TAE (23) or TACE (12) with RFA (15) or MWA (20) from 1/2009–6/2015 as either definitive therapy or a bridge to transplant. TAE and TACE were performed with 40–400 μm particles and 30–100 μm plus either Doxorubicin or Epirubicin eluting microspheres respectively. Initial response and local progression were evaluated using modified Response Evaluation Criteria in Solid Tumors (mRECIST). Complications were graded using Common Terminology Criteria for Adverse Events (CTCAE) version 5.0. Results Complete response (CR) rates were 80% (12/15) for RFA + TAE/TACE and 95% (19/20) for MWA + TAE/TACE (p value 0.29). Local recurrence (LR) was 30% (4/12) for RFA + TAE/TACE and 0% (0/19) for MWA + TAE/TACE. Durability of response (DR), defined as local disease control for duration of the study, demonstrated a significant difference in favor of MWA (p value 0.0091). There was no statistical difference in complication rates (3 vs 2). Conclusions MWA and RFA when combined with neoadjuvant TAE or TACE have similar safety and efficacy in the treatment of early stage HCC. MWA provided more durable disease control in this study, however, prospective data remains necessary to evaluate superiority of either modality.

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“…Initial follow up was performed with multiphase CT or MRI post ablation (11). Institutional guidelines dictated that initial follow up imaging be obtained at 1 month post procedure.…”

Section: Methodsmentioning

confidence: 99%

Radiofrequency vs Microwave Ablation After Neoadjuvant Transarterial Bland and Drug-Eluting Microsphere Chembolization for the Treatment of Hepatocellular Carcinoma

Thornton

Cabrera

Kapp

et al. 2017

Current Problems in Diagnostic Radiology

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“…It is well understood that the majority of local recurrences of malignant hepatic tumors more likely appears during the first year following RFA. 32 Therefore, the search of local recurrence should be made as soon as possible. Unfortunately, the detection of local hepatic tumor recurrence remains challenging.…”

Section: Discussionmentioning

confidence: 99%

One‐month apparent diffusion coefficient correlates with response to radiofrequency ablation of hepatocellular carcinoma

Barat

Fohlen

Cassinotto

et al. 2016

Magnetic Resonance Imaging

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“…No established guidelines for ideal surveillance time intervals exist. Recurrence is 6.5 times more likely to occur in the first year after therapy than in the second year, so most guidelines suggest 3 monthly interval imaging in the first year after treatment [58]. We follow up with imaging at 3 month intervals for one year followed by 6 month intervals for 2 years, and then we return to ultrasound screening.…”

Section: Post Therapy Imagingmentioning

confidence: 99%

Imaging of hepatocellular carcinoma and image guided therapies - how we do it

et al. 2017

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Treatment options for hepatocellular carcinoma have evolved over recent years. Interventional radiologists and surgeons can offer curative treatments for early stage tumours, and locoregional therapies can be provided resulting in longer survival times. Early diagnosis with screening ultrasound is the key. CT and MRI are used to characterize lesions and determine the extent of tumour burden. Imaging techniques are discussed in this article as the correct imaging protocols are essential to optimise successful detection and characterisation. After treatment it is important to establish regular imaging follow up with CT or MRI as local residual disease can be easily treated, and recurrence elsewhere in the liver is common.

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Optimal Imaging Surveillance Schedules after Liver-Directed Therapy for Hepatocellular Carcinoma

Cited by 54 publications

References 9 publications

Radiofrequency vs Microwave Ablation After Neoadjuvant Transarterial Bland and Drug-Eluting Microsphere Chembolization for the Treatment of Hepatocellular Carcinoma

Radiofrequency vs Microwave Ablation After Neoadjuvant Transarterial Bland and Drug-Eluting Microsphere Chembolization for the Treatment of Hepatocellular Carcinoma

One‐month apparent diffusion coefficient correlates with response to radiofrequency ablation of hepatocellular carcinoma

Imaging of hepatocellular carcinoma and image guided therapies - how we do it

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