Acoustic radiation force impulse elastography for hepatocellular carcinoma-associated radiofrequency ablation

Figure 4 Recurred hepatocellular carcinoma after radiofrequency ablation in a 65-year-old man with underlying liver cirrhosis. A: Follow-up post-radiofrequency ablation (RFA) computed tomography (CT) scan shows the ablation zone of low attenuation without residual or recurrent tumor in segment 5 of the liver (arrow); B: Contrast-enhanced CT scan obtained after 6 mo shows enhancing nodule in the ablated lesion (asterisk). The serum alpha-fetoprotein increased from 2.6 ng/mL to 16.8 ng/mL; C: On a B-mode image, prior RFA site and recurred hepatocellular carcinoma (HCC) are seen as homogeneous hyperechoic lesions and subtle heterogeneous echogenic nodules with a thin hypoechoic rim (arrows). The recurred HCC appears as a brighter color (softer) with a distinct border on the acoustic radiation force impulse image.