Transarterial Chemoembolization versus Radiofrequency Ablation for Small Hepatocellular Carcinomas with Discrepant Features on Computed Tomography and Magnetic Resonance Imaging |
Young Youn Cho1, Jung Hee Kwon1, Jeong-Hoon Lee1, Jeong Min Lee2, Jae Young Lee2, Hyo-Choel Kim2, Jin Wook Chung2, Won-mook Choi1, Eun Ju Cho1, Yoon Jun Kim1, Jung-Hwan Yoon1, Chung Yong Kim1, Hyo-Suk Lee1 |
1Department of Internal Medicine and Liver Research Institute Seoul National University College of Medicine, Seoul, Korea 2Department of Radiology,Seoul National University College of Medicine, Seoul, Korea |
Correspondence:
Jeong-Hoon Lee, Email: pindra@empal.com |
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Abstract |
Background/Aims This study compared the outcomes of patients with small hepatocellular
carcinomas (HCCs) who were treated using transarterial chemoembolization (TACE) or
radiofrequency ablation (RFA). Methods This was a post-hoc analysis of a prospective study that evaluated the diagnostic
efficacy of magnetic resonance imaging (MRI) and computed tomography (CT). We analyzed
41 small hepatic nodules in 32 patients that showed typical radiologic hallmarks on both CT
and gadoxate-enhanced MRI (typical nodules) and 25 small hepatic nodules from 22 patients
that showed atypical radiologic hallmarks on CT and typical radiologic hallmarks on MRI
(discrepant nodules). Results There were no significant differences in the baseline characteristics of the patients
with typical and discrepant nodules. Complete response rates 1 month after TACE or RFA were
75.0% (18/24) and 94.1% (16/17; P=0.20), respectively, for the patients with typical nodules
and 58.8% (10/17) and 100% (8/8; P=0.05), respectively, for the patients with discrepant
nodules. Treatment failure rates after TACE or RFA were 33.3% (8/24) and 5.8% (1/17; P=0.15),
respectively, for the patients with typical nodules and 47.0% (8/17) and 0.0% (0/8; P=0.02),
respectively, for the patients with discrepant nodules. Among patients achieving complete
response, there were no significant differences in the risk of marginal recurrence. Conclusions RFA provided higher complete response rates and significantly lower treatment failure rates than TACE for patients with discrepant nodules of HCC. Therefore, a treatment
modality such as RFA may be preferable for small HCCs which show discrepancy on two
imaging modalities.
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Key Words:
Hepatocellular carcinoma; Multidetector computed tomography; Magnetic resonance imaging |
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