Table 2 Recommended imaging protocol and follow-up schedule
| Â | Kidney | Liver | Lung |
|---|---|---|---|
Follow-up schedule | First year: 1, 3, 6 , 12 months Thereafter: every 12 months (chest imaging every 12 months) | First year: 1, 3, 6, 9, 12 months Thereafter: every 6 months Consider shortening of interval in high risk patients or other signs of recurrence | First year: 1, 3, 6, 9, 12 months (optional: before discharge after ablation) Thereafter: every 6 months |
Recommended modalities | 1. CT or MRI of the kidneys 2. Biopsy only after 6 months in case of suspected recurrence | 1. Primary MRI (mandatory after TACE with Lipiodol), secondary CT 2. PET-CT only for metastases > 2cm and not for HCC 3. PET-CT (if available) within 48h after ablation 4. PET-CT as a problem solver and in case of suspected LTP 5. Biopsy of ablation margin can be considered in margins < 5mm (➔optional to replace MRI at 6 and 12 months by PET-CT) | 1. CT 2. PET-CT not before 6 months, only in case of suspected recurrence (and targeted biopsy for recurrence), whole-body evaluation |
Computed tomography | unenhanced | unenhanced (HCC) | unenhanced CT optional to establish enhancement compared to baseline late arterial (35s) after treatment |
| Â | arterial phase (20-30s) | late arterial (35-40s) (HCC) | Â |
| Â | nephrogenic phase (100s) | portal-venous (70s) (CRLM+HCC) | venous (70s) optional, if available |
|  | delayed phase (10 min; to assess complications) | late venous (≥120s) (HCC) |  |
| Â | slice thickness maximally 3 mm | slice thickness maximally 3 mm | slice thickness 1 mm |
Magnetic resonance imaging | axial T2W (with and without fatsat) | axial GRE in and opposed phase T1W | Â |
| Â | axial and coronal dual echo | axial T2W FSE (with and without fatsat | Â |
| Â | axial dynamic 3D GRE before and after Gd (20/70/180s) | axial dynamic 3D fatsat GRE before and after Gd (20/70/180s) | Â |
| Â | axial 5 min post contrast GRE | axial 20 min after hepatobiliary specific Gd agent | Â |
| Â | axial DWI | axial DWI | Â |
| Â | Â | subtraction images are highly recommended for HCC | Â |
| Â | Â | axial and coronal T2 HASTE | Â |
PET-CT | NA | Only in CRLM: standard protocol for FDG-PET-CT | standard protocol for FDG-PET-CT |