Factors Affecting Temporal Changes in Ablated Liver Volume After Radiofrequency Ablation for Hepatocellular Carcinoma Evaluated by Three-Dimensional Volumetric Computed Tomography.
In a retrospective cohort of 41 predominantly older adults with hepatocellular carcinoma, six-month shrinkage of the CT-defined radiofrequency ablation volume was lower with impaired liver function, advanced fibrosis, and certain hepatic lesion locations, with albumin and total bilirubin independently associated with shrinkage rate.
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In a retrospective cohort of 41 predominantly older adults with hepatocellular carcinoma, six-month shrinkage of the CT-defined radiofrequency ablation volume was lower with impaired liver function, advanced fibrosis, and certain hepatic lesion locations, with albumin and total bilirubin independently associated with shrinkage rate.
Research significance
The study provides observational evidence that baseline liver function is associated with post-RFA ablation-volume evolution; it may be inferred—but is not demonstrated—that serial volumetric CT combined with albumin and bilirubin could help interpret treatment response or tailor surveillance after RFA.
Source abstract
OBJECTIVES: To evaluate associations between shrinkage of ablated liver area on computed tomography (CT) over time after radiofrequency ablation (RFA) and clinical parameters related to liver function and fibrosis. METHODS: Patients with hepatocellular carcinoma who underwent RFA and follow-up CT were retrospectively reviewed. The ablated area volume (AAV) on CT obtained within 1 week and around 6 months after RFA was measured, and reduction rate of AAV was calculated. The AAV reduction rate was compared among Child-Pugh classification, modified albumin-bilirubin (mALBI) grades, FIB-4 index categories, and lesion locations using generalized estimating equations (GEE). Univariable and multivariable GEE analyses were performed to evaluate associations between the AAV reduction rate and clinical parameters. RESULTS: Fifty-three lesions in 41 patients (median age, 76 [range, 38-88] years, 24 men) were evaluated. The AAV reduction rate was significantly lower in Child-Pugh class B than class A (p < 0.001) and in mALBI grade 2b than grade 1 (p < 0.001) or grade 2a (p = 0.004). Significant differences were also observed among FIB-4 index groups (p < 0.001) and among lesion locations, with lower AAV reduction rates in medial and anterior segments than in lateral (p < 0.001) and posterior (p = 0.017) segments. Univariable GEE analyses showed significant associations between AAV reduction rate and cholinesterase, albumin, total bilirubin (T-Bil), prothrombin time, platelet count, and FIB-4 index (p < 0.05). Multivariable GEE analysis demonstrated that both albumin and T-Bil remained independently associated with AAV reduction rate (p < 0.001). CONCLUSIONS: The AAV reduction rate tended to be lower in patients with impaired liver function and advanced liver fibrosis.