Prediction of hepatic cyst recurrence after minocycline hydrochloride aspiration sclerotherapy using cyst computed tomography values

Aim Polycystic liver disease (PLD) occasionally leads to abdominal pain, distention, and discomfort due to massively enlarged cysts. Patients with small number of large liver cysts, which correspond to Gigot's classification type 1 PLD, are said to be good candidates for treatment by aspiration sclerotherapy. However, there is a 21% reported recurrence rate of an enlarged cyst. A rule to predict outcome of aspiration sclerotherapy is explored in this study. Methods Autosomal dominant polycystic kidney disease or isolated polycystic liver disease patients receiving minocycline hydrochloride cyst aspiration sclerotherapy for their symptomatic PLD were retrospectively analyzed by medical records. Cysts’ volume changes between before and one year after treatment were calculated using CT images. Mean CT values of the largest planes of cysts were also calculated. Specific gravity and other laboratory parameters of aspirated cysts fluid were also retrospectively investigated. Results In total, 12 patients were selected and 21 cysts receiving aspiration sclerotherapy were analyzed. Mean CT values more than 13.34 HU were predictive for one-year non-sustainability of a cyst volume of less than 30% compared with the volume prior to the therapy. Specific gravity had good positive correlation with mean CT value and other laboratory parameters indicating exudative property were also high in recurred cysts. Conclusions Cysts’ CT values may become an aid in appropriate selection of therapy modality in symptomatic polycystic disease patients by telling cysts that are resistant to aspiration sclerotherapy.