Learning objectives
The aim of this educational exhibit is to describeimaging features of malignant hepatic lesions during and after interventional radiology procedures.
Background
HCC,
cholangiocarcinoma and metastases may require interventional radiology treatments for their management.
Hepatocellular carcinoma (HCC) is one of the most common cancers in the world.
Surgical resection and liver transplantation are the only potentially curative options for HCC,
but less than 20% of patients are eligible for these treatments because of advanced disease with multifocal tumour spread or gross vascular invasion,
extrahepatic tumour spread or inadequate functional liver reserve related to co-existent cirrhosis.
Other available imaging guided tools for the treatment of HCC are RFA...
Findings and procedure details
Interventional radiology procedures need accurate staging of disease before treatment: radiologists should carefully report number,
size and location of lesions; in addition,
vascular patency or infiltration should be evaluated.
It is very important to recognise abnormal post-interventional radiology procedures imaging findings and differentiation of abnormal findings from normal postprocedural changes.
Ultrasound is generally used in screening and is not recommended for follow up of patients with treated hepatic lesions.
However,
there is increasing interest in using contrast-enhanced ultrasound (CEUS) to assess response to locoregional therapy,...
Conclusion
The knowledge of imaging features after interventional radiology treatments is mandatory to assess residual/recurrence disease.
Early identification of residual or recurrent disease and complications can facilitate timely retreatment,
management and follow-up care.
References
[1] Agnello F.,
Selvaggio G.
et al. Imaging appearance of treated hepatocellular carcinoma,
World J Hepatol,
2013; 5(8): 417-424
[2] Aubè C.,
Oberti F.
et al.
Radiological treatment of hcc: interventional radiology at the heart of management,
Diagn Interv Imaging 2015; 96(6): 625-636
[3] Llovet JM,
Ducreux M.
et al.
EASL-EORTC clinical practice guidelines: man-agement of hepatocellular carcinoma.
Eur J Cancer 2012; 48(5): 599-641
[4] Kinoshita A.,
Onoda H.
et al.
Staging systems for hepatocellular carcinoma: current status and future perspectives,
World J Hepatol 2015;7(3):...