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Growth Rate of Hepatocellular Carcinoma: Evaluation With Serial Computed Tomography or Magnetic Resonance Imaging

Taouli, Bachir MD*; Goh, Jeffrey S. K MD*; Lu, Ying PhD; Qayyum, Aliya MBBS*; Yeh, Benjamin M MD*; Merriman, Raphael B MBBCh; Coakley, Fergus V MD*

Journal of Computer Assisted Tomography: July-August 2005 - Volume 29 - Issue 4 - p 425-429
doi: 10.1097/01.rct.0000164036.85327.05
Abdominal Imaging: Original Article

Objective: To evaluate the growth rate of untreated hepatocellular carcinoma (HCC) by calculating tumor volume doubling time (TVDT) on serial computed tomography (CT) or magnetic resonance imaging (MRI) and to predict TVDT based on initial tumor size.

Methods: Sixteen untreated HCCs in 11 patients with cirrhosis who underwent serial CT or MRI at our institution were retrospectively identified. Two independent readers recorded bidimensional measurements for all tumors, which were used to determine tumor volume (TV). Growth rate was expressed as TVDT. A mathematic model was used to predict TVDT based on baseline tumor size.

Results: Mean baseline and follow-up TVs were 10.5 cm3 (range: 0.7-243.6 cm3) and 22.0 cm3 (range: 2.5-870.8 cm3), respectively. Mean duration of follow-up was 176 days (range: 76-472 days). Mean TVDT was 127 days (95% confidence interval: 80, 203; range: 17.5-541.4 days). Expected TVDT could be expressed as TVDT = 114 × (baseline volume) 0.14 (P < 0.002).

Conclusion: The results of this study suggest a preferred interval follow-up of approximately 4.5 months (127 days) for HCC screening. Small HCCs show a tendency toward faster growth and may require shorter follow-up to demonstrate progression.

From the *Department of Radiology, University of California, San Francisco, San Francisco, CA, †Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, and ‡Division of Gastroenterology, Department of Medicine, University of California, San Francisco, San Francisco, CA.

Received for publication December 22, 2004; accepted March 16, 2005.

Reprints: Bachir Taouli, Department of Radiology, New York University Medical Center, 560 First Avenue, TCH-HW 202, New York, NY 10016-6497 (e-mail:

© 2005 Lippincott Williams & Wilkins, Inc.