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Cancer Imaging

Open Access

Value of pretreatment MRI determined parameters for predicting outcome after radio-frequency ablation of hepatocellular carcinoma

  • R Dresen1Email author,
  • K Michielsen1,
  • F De Keyzer1,
  • C Verslype2,
  • B Topal3,
  • R Aerts3 and
  • V Vandecaveye1
Cancer Imaging201515(Suppl 1):S7

Published: 2 October 2015


Hepatocellular CarcinomaDisease Free SurvivalImaging ParameterImaging PatternHepatobiliary Phase


To evaluate whether pretreatment magnetic resonance imaging (MRI) determined imaging parameters are predictive for outcome in hepatocellular carcinoma (HCC) treated with radio-frequency ablation (RFA).


Thirty-seven patients with HCC treated by RFA were evaluated. Lesion number, size and segmental location, T2-weighted (w), arterial, portal-venous and venous contrast-phase, b600 diffusion-w imaging (DWI) and delayed phase contrast-enhanced imaging pattern were assessed at MRI. The separate imaging patterns as well as pretreatment clinical variables were correlated with outcome (disease free survival longer or shorter than 1 year) using a chi-square test with multiple variables and Mann-Whitney U test respectively. Pretreatment clinical variables and imaging parameters were correlated with Keratin 19 and microvascular invasion status at the biopsy during RFA.


None of the pretreatment patient- or tumour-related parameters correlated to disease free survival (p>0.5).

The portal-venous, venous phase and b600 DWI imaging pattern showed strongest correlation with disease free survival (p=0.00023, p=0.00003 and p=0.0002 respectively). Also correlation was found for T2w imaging pattern (p=0.007), and hepatobiliary phase imaging pattern (p=0.017). Patients with tumour recurrence within 1 year (n=14) showed persistent venous rim- or nodular enhancement in 13 patients and b600 DWI rim-like hyperintensity in 9 patients correlating with microvascular invasion at biopsy (p=0.04). Patients disease free for at least 1 year (n=23) showed venous wash-out in 22 of 23 patients and whole-lesion hyperintensity b600 DWI in 18 patients.


Pretreatment venous rim-enhancement and rim-like intensity at b600 DWI were strongest predictors of treatment failure within the first year after RFA of HCC.

Authors’ Affiliations

Department of Radiology, Leuven Cancer Institute, University Hospitals Leuven, KU Leuven, Belgium
Department of Hepatology, Leuven Cancer Institute, University Hospitals Leuven, KU Leuven, Belgium
Department of Surgery, Leuven Cancer Institute, University Hospitals Leuven, KU Leuven, Belgium


© Dresen et al. 2015

This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated.