Mid-term Outcome of Positron Emission Tomography/Computed Tomography-assisted Radiofrequency Ablation in Primary and Secondary Liver Tumours - A Single-centre Experience

Aims: To determine the mid-term results of percutaneous radiofrequency ablation (RFA) of malignant liver tumours when using FDG-positron emission tomography (FDG-PET)/computed tomography for tumour evaluation and follow-up. Materials and methods: Between January 2002 and June 2006, 55 patients (mean age 63 years) with 78 liver lesions (39 colorectal metastases, 39 hepatocellular carcinoma [HCC] nodules) were treated with RFA. All patients received PET/computed tomography before intervention. RFA was performed under computed tomography guidance with conscious sedation. Post-interventional PET/computed tomography was carried out in PET-positive patients 24 h after the ablation and was repeated at 1, 3 and 6 months and every 6 months after the intervention. PET-negative patients received contrast-enhanced computed tomography at the same time points. The rate of local tumour progression (LTP) and survival rates were assessed for the whole patient population. Results: The 78 lesions (mean size 2.3 cm, range 0.8-5 cm) were treated with 101 consecutive ablation procedures resulting in a technical success rate of 96%. The mean time of follow-up was 25 ± 12 months. Thirty-five of 78 tumours (45%) developed LTP. At the end of follow-up, LTP was found in 22 patients (40%), with intra- and extrahepatic recurrence in 11 patients. Twenty-two patients remained free of hepatic tumours. The 1-, 2- and 3-year survival rates were 85, 74 and 58%, respectively. Tumour entity, lesion size and localisation were significant risk factors for LTP. Conclusions: Computed tomography-guided RFA of malignant liver tumours is effective, but shows a high rate of LTP. PET/computed tomography supports RFA by early identification of residual tumour or LTP.