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Complications of Percutaneous Radiofrequency Ablation for Hepato-cellular Carcinoma: Imaging Spectrum and Management¹

¹ From the Departments of Radiology (M.A., H.K., N.K., H.Y., K.U., K.O.) and Gastroenterology (R.T., T.T., S.S.), Graduate School of Medicine, University of Tokyo, 7–3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan. Presented as an education exhibit at the 2004 RSNA Annual Meeting. Received February 7, 2005; revision requested April 18 and received May 27; accepted June 3. All authors have no financial relationships to disclose. Address correspondence to M.A. (e-mail: akahane-tky{at}umin.ac.jp).

Percutaneous radiofrequency (RF) ablation is feasible for the treatment of unresectable hepatocellular carcinoma, and experience at the authors’ institution during 5 years indicates that percutaneous RF ablation can be performed safely in most cases. However, early or late complications related to mechanical or thermal damage may be observed at follow-up examination. Complications may be classified in three groups: vascular (eg, portal vein thrombosis, hepatic vein thrombosis with partial hepatic congestion, hepatic infarction, and subcapsular hematoma), biliary (eg, bile duct stenosis and biloma, abscess, and hemobilia), and extrahepatic (eg, injury to the gastrointestinal tract, injury to the gallbladder, pneumothorax and hemothorax, and tumor seeding). Most complications can be managed with conservative treatment, percutaneous or endoscopic drainage, or surgical repair. Because an early and accurate diagnosis is necessary for proper management, radiologists should be familiar with the imaging features of each type of complication.

© RSNA, 2005

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