Hepatocellular Carcinoma Presenting at Contrast-Enhanced Multi-Detector-Row Computed Tomography or Gadolinium-Enhanced Magnetic Resonance Imaging as a Small (≤2 cm), Indeterminate Nodule: Growth Rate and Optimal Interval Time for Imaging Follow-Up

Objective: The objective of the study was to measure growth rate and to determine the optimal interval time for imaging follow-up of hepatocellular carcinomas (HCCs) presenting at multi-detector-row computed tomography (MDCT) or magnetic resonance imaging (MRI) as small, indeterminate lesions. Methods: We included patients with cirrhosis with HCC initially presenting as indeterminate lesion of 2 cm or less at MDCT or MRI August 2005 to August 2009 and with available imaging follow-up. Measures of tumor growth included tumor volume doubling time (TVDT), tumor percentual diameter increase, and tumor percentual volume increase. Results: We examined 48 patients (mean age, 64 years) with 69 HCCs. At index examination, mean (SD) maximum transverse diameter and volume of lesions were 1.2 (SD, 0.3) cm and 0.6 (SD, 0.7) cm(3), respectively. Median TVDT was 210 days. Tumors with follow-up longer than 365 days had significant increase in tumor percentual diameter increase and tumor percentual volume increase. Conclusions: Median TVDT of 210 days suggests extended follow-up of 6 months for small, indeterminate liver nodules detected at MDCT or MRI.