BACKGROUND: RFA and MWA offer minimally-invasive intervention to a widening array of patients with localized hepatocellular carcinoma (HCC) and certain metastatic liver lesions. These can represent definitive liver directed therapy or bridging to hepatic transplant. Clinical management following ablation is dependent on diagnostic imaging to characterize expected post-ablative changes, residual disease, and disease recurrence across multiple time points. Post-procedural complications include biliary dilatation, biloma, hepatic abscess, bleeding, pseudoaneurysm, liver infarct, tract seeding, and cholecystocolonic fistula.

CONCLUSION: As percutaneous ablative techniques are more widely utilized in both monotherapy and as adjuncts to surgery, radiologists must be familiar with the sequential appearances of expected outcomes and complications. Accurate diagnostic imaging is crucial to the early recognition and timely management of the post-procedural patient.

IMAGING FINDINGS FOLLOWING PERCUTANEOUS ABLATION OF LIVER LESIONS