Clinical significance of contrast extravasation on computed tomography immediately after thermal ablation for hepatic tumors

Abstract Background To evaluate the clinical significance of contrast extravasation observed on post-ablation computed tomography (CT) performed immediately following thermal ablation of hepatic tumors. Methods Between October 2014 and December 2023, 1,274 patients with 1,745 primary or metastatic h...

Full description

Saved in:
Bibliographic Details
Main Authors: Dong Kyu Kim, Joon Ho Kwon, Kichang Han, Juil Park, Gyoung Min Kim, Man-Deuk Kim, Jong Yun Won
Format: Article
Language:English
Published: BMC 2025-07-01
Series:BMC Gastroenterology
Subjects:
Online Access:https://doi.org/10.1186/s12876-025-04025-4
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849238313990356992
author Dong Kyu Kim
Joon Ho Kwon
Kichang Han
Juil Park
Gyoung Min Kim
Man-Deuk Kim
Jong Yun Won
author_facet Dong Kyu Kim
Joon Ho Kwon
Kichang Han
Juil Park
Gyoung Min Kim
Man-Deuk Kim
Jong Yun Won
author_sort Dong Kyu Kim
collection DOAJ
description Abstract Background To evaluate the clinical significance of contrast extravasation observed on post-ablation computed tomography (CT) performed immediately following thermal ablation of hepatic tumors. Methods Between October 2014 and December 2023, 1,274 patients with 1,745 primary or metastatic hepatic tumors underwent ablation, including radiofrequency ablation, microwave ablation, and cryoablation. Among them, 30 patients (median age: 66 years) with contrast extravasation observed on post-ablation CT scans were retrospectively analyzed. The pre- and post-ablation hemoglobin and hematocrit levels were measured. Local tumor progression-free survival (LTPFS) and overall survival (OS) rates were evaluated. Results Among the 30 patients, angiography was performed in 6 patients. Contrast extravasation was observed on angiography in only two patients; contrast extravasation from the right inferior phrenic artery and intercostal artery was noted, and successful transarterial embolization was achieved. Conservative management was considered adequate without additional treatment in 28 of 30 patients. No significant differences were observed between the 1 day before and after ablation hemoglobin (12.9 g/dL; 12.0–13.8 g/dL vs. 12.5 g/dL; 11.5–13.8 g/dL, P = 0.102) and hematocrit (38.3%; 36.0–40.1% vs. 37.0%; 34.8–39.2%, P = 0.100) levels. During a mean follow up period of 23.3 ± 17.8 months, the LTPFS rates were 96.4% and 84.3% at 1 and 2 years, respectively. The OS rate after the procedure was 96.7%. Conclusion The presence of contrast extravasation on post-ablation CT was not clinically significant, when extravasation confined to intrahepatic or venous origins. However, transarterial embolization is required if contrast extravasation is detected in the extrahepatic arteries.
format Article
id doaj-art-8d46a88dddf54b45a070102765947db2
institution Kabale University
issn 1471-230X
language English
publishDate 2025-07-01
publisher BMC
record_format Article
series BMC Gastroenterology
spelling doaj-art-8d46a88dddf54b45a070102765947db22025-08-20T04:01:41ZengBMCBMC Gastroenterology1471-230X2025-07-012511910.1186/s12876-025-04025-4Clinical significance of contrast extravasation on computed tomography immediately after thermal ablation for hepatic tumorsDong Kyu Kim0Joon Ho Kwon1Kichang Han2Juil Park3Gyoung Min Kim4Man-Deuk Kim5Jong Yun Won6Department of Radiology, Yongin Severance Hospital, Research Institute of Radiological Science, Yonsei University College of MedicineDepartment of Radiology, Severance Hospital, Research Institute of Radiological Science, Yonsei University College of MedicineDepartment of Radiology, Severance Hospital, Research Institute of Radiological Science, Yonsei University College of MedicineDepartment of Radiology, Severance Hospital, Research Institute of Radiological Science, Yonsei University College of MedicineDepartment of Radiology, Severance Hospital, Research Institute of Radiological Science, Yonsei University College of MedicineDepartment of Radiology, Severance Hospital, Research Institute of Radiological Science, Yonsei University College of MedicineDepartment of Radiology, Severance Hospital, Research Institute of Radiological Science, Yonsei University College of MedicineAbstract Background To evaluate the clinical significance of contrast extravasation observed on post-ablation computed tomography (CT) performed immediately following thermal ablation of hepatic tumors. Methods Between October 2014 and December 2023, 1,274 patients with 1,745 primary or metastatic hepatic tumors underwent ablation, including radiofrequency ablation, microwave ablation, and cryoablation. Among them, 30 patients (median age: 66 years) with contrast extravasation observed on post-ablation CT scans were retrospectively analyzed. The pre- and post-ablation hemoglobin and hematocrit levels were measured. Local tumor progression-free survival (LTPFS) and overall survival (OS) rates were evaluated. Results Among the 30 patients, angiography was performed in 6 patients. Contrast extravasation was observed on angiography in only two patients; contrast extravasation from the right inferior phrenic artery and intercostal artery was noted, and successful transarterial embolization was achieved. Conservative management was considered adequate without additional treatment in 28 of 30 patients. No significant differences were observed between the 1 day before and after ablation hemoglobin (12.9 g/dL; 12.0–13.8 g/dL vs. 12.5 g/dL; 11.5–13.8 g/dL, P = 0.102) and hematocrit (38.3%; 36.0–40.1% vs. 37.0%; 34.8–39.2%, P = 0.100) levels. During a mean follow up period of 23.3 ± 17.8 months, the LTPFS rates were 96.4% and 84.3% at 1 and 2 years, respectively. The OS rate after the procedure was 96.7%. Conclusion The presence of contrast extravasation on post-ablation CT was not clinically significant, when extravasation confined to intrahepatic or venous origins. However, transarterial embolization is required if contrast extravasation is detected in the extrahepatic arteries.https://doi.org/10.1186/s12876-025-04025-4Hepatic tumorAblationContrast extravasationComputed tomographyAngiography
spellingShingle Dong Kyu Kim
Joon Ho Kwon
Kichang Han
Juil Park
Gyoung Min Kim
Man-Deuk Kim
Jong Yun Won
Clinical significance of contrast extravasation on computed tomography immediately after thermal ablation for hepatic tumors
BMC Gastroenterology
Hepatic tumor
Ablation
Contrast extravasation
Computed tomography
Angiography
title Clinical significance of contrast extravasation on computed tomography immediately after thermal ablation for hepatic tumors
title_full Clinical significance of contrast extravasation on computed tomography immediately after thermal ablation for hepatic tumors
title_fullStr Clinical significance of contrast extravasation on computed tomography immediately after thermal ablation for hepatic tumors
title_full_unstemmed Clinical significance of contrast extravasation on computed tomography immediately after thermal ablation for hepatic tumors
title_short Clinical significance of contrast extravasation on computed tomography immediately after thermal ablation for hepatic tumors
title_sort clinical significance of contrast extravasation on computed tomography immediately after thermal ablation for hepatic tumors
topic Hepatic tumor
Ablation
Contrast extravasation
Computed tomography
Angiography
url https://doi.org/10.1186/s12876-025-04025-4
work_keys_str_mv AT dongkyukim clinicalsignificanceofcontrastextravasationoncomputedtomographyimmediatelyafterthermalablationforhepatictumors
AT joonhokwon clinicalsignificanceofcontrastextravasationoncomputedtomographyimmediatelyafterthermalablationforhepatictumors
AT kichanghan clinicalsignificanceofcontrastextravasationoncomputedtomographyimmediatelyafterthermalablationforhepatictumors
AT juilpark clinicalsignificanceofcontrastextravasationoncomputedtomographyimmediatelyafterthermalablationforhepatictumors
AT gyoungminkim clinicalsignificanceofcontrastextravasationoncomputedtomographyimmediatelyafterthermalablationforhepatictumors
AT mandeukkim clinicalsignificanceofcontrastextravasationoncomputedtomographyimmediatelyafterthermalablationforhepatictumors
AT jongyunwon clinicalsignificanceofcontrastextravasationoncomputedtomographyimmediatelyafterthermalablationforhepatictumors