Rim-arterial enhancing primary hepatic tumors with other targetoid appearance show early recurrence after radiofrequency ablation

• Published in: European radiology Vol. 31; no. 9; pp. 6555 - 6567
• Main Authors: Cha, Dong Ik, Lee, Min Woo, Jeong, Woo Kyoung, Ahn, Soo Hyun, Kang, Tae Wook, Song, Kyoung Doo, Min, Ji Hye, Rhim, Hyunchul, Lim, Hyo Keun
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.09.2021; Springer Nature B.V
• Subjects: Ablation; Diagnostic Radiology; Hazard assessment; Imaging; Internal Medicine; Interventional; Interventional Radiology; Liver; Liver cancer; Medicine; Medicine & Public Health; Metastases; Metastasis; Neuroradiology; Radio frequency; Radiofrequency ablation; Radiology; Rank tests; Statistical models; Tumors; Ultrasound; Carcinoma, hepatocellular; Radiofrequency ablation; Recurrence; Magnetic resonance imaging
• ISSN: 0938-7994; 1432-1084
• DOI: 10.1007/s00330-021-07769-1

Objectives To evaluate early (≤ 2 years) local tumor progression (LTP), intrahepatic distant metastasis (IDR), and extrahepatic metastasis (EM) of primary hepatic malignant tumors with arterial rim enhancement (RE) after RFA in comparison with non-RE tumors. Methods Three hundred forty-nine patients who underwent RFA for primary hepatic malignant tumors between January 2009 and December 2016 were included. The patients’ tumors were classified into non-RE, RE only (RO), and RE plus other targetoid appearances (REoT). Cumulative LTP, IDR, and EM rates at 1 and 2 years after RFA were calculated using the Kaplan-Meier method and compared using the log-rank test. Prognostic factors for the outcomes were assessed using a Cox proportional hazards model. Results There were 303 non-RE, 19 RO, and 27 REoT tumors. The REoT tumors had a significantly higher rate of IDR and EM than non-RE ( p = 0.04 for IDR; and p < 0.01 for EM, respectively) at 1 year after RFA. At 2 years, LTP and EM rates were significantly higher for REoT than for non-RE ( p = 0.001 for LTP; and p = 0.444 for EM, respectively). The RO tumors did not have different outcomes than non-RE at 1 and 2 years after RFA. Multivariable analysis verified that REoT was a significant factor for IDR ( p = 0.04) and EM ( p = 0.01) at 1 year and LTP ( p = 0.02) at 2 years. Conclusions Tumors with REoT had poor LTP, IDR, and EM within 2 years after RFA than non-RE tumors. However, tumors with RO showed similar results as non-RE tumors. Key Points • Tumors with Rim enhancement plus other targetoid appearances (REoT) had a significantly higher rate of recurrence than non-rim enhancing (RE) tumors at 1 and 2 years after RFA. • Tumors with rim enhancement only did not have different outcomes than non-RE at 1 and 2 years after RFA.