Hepatic volumetry to predict adverse events in percutaneous ablation of hepatocellular carcinoma

Background/Aims: This study aimed to clarify the relation of hepatic volumetry to adverse events after percutaneous transhepatic ablation for hepatocellular carcinoma. Methodology: One hundred and forty-nine patients with hepatocellular carcinoma who underwent percutaneous ablation sessions with complete ablation of cancer nodules, underwent volume measurement of the entire liver, tumor, and ablated area using computed tomography. The parenchymal ablation rate was calculated: (ablated volume-tumor volume)/(entire liver volume-tumor volume) × 100 (%). Other clinical parameters were also analyzed to determine their relationship to adverse events. Results: The median adjusted liver volume was 591mL/body surface area (m²) (range: 300 to 1197mL/m²). The median parenchymal ablation rate was 2.3% (range: 0.2% to 20.2%). Adverse events were observed in 17 patients after percutaneous ablation: liver abscess in 3, hepatic infarction in 3, portal vein thrombus in 3, hemobilia in 1, pleural effusion and/or ascites in 6, and gastric ulcer in 1. Multivariate analysis showed that Child B or C (P=0.0009), adjusted liver volume <600mL/m² (P=0.0004), and parenchymal ablation rate >5% (P=0.0320) were independent risk factors for adverse events. Conclusions: Measurement of liver volume and parenchymal ablation rate are useful to predict the presence of percutaneous ablation-related adverse events.