A-F. 63-year-old female patient with multicentric HCC (patient #8). Axial nonenhanced T1WI performed at baseline showed a 10 cm large tumor (arrow) in the left liver lobe (Figure 1A). Note a tumor signal (arrow) slightly hypointense to normal liver parenchyma with a small ventral heterogeneous hyperintense area caused by earlier radiofrequency (RFA) ablation. On baseline T2WI, the tumor revealed diffuse mild hyperintensity and a small hypointense area corresponding to the ablation site (Figure 1B). Baseline fat-suppressed post-gadolinium (Gd) imaging demonstrated diffuse tumor enhancement (arrows) with focal necrosis due to the earlier RFA procedure (arrowhead) (Figure 1C). Three weeks after onset of sorafenib, T1WI imaging detected multiple focal hyperintense lesions (arrows) in part with sedimentation levels that have occurred during therapy (Figure 1D). On T2WI at the same time, corresponding hyperintense lesions were seen (arrows) (Figure 1E). Fat-suppressed post-Gd imaging revealed extensive necrosis (arrows) and reduction in tumor perfusion (Figure 1F).
Horger et al. BMC Cancer 2009 9:208 doi:10.1186/1471-2407-9-208