A-F. 71-year-old male patient with multifocal HCC (patient #9). Axial nonenhanced fat-suppressed T1WI imaging of the liver performed at baseline showed multiple mild hypointense HCC lesions (arrow) (Figure 2A). On corresponding coronal HASTE (T2-weighted) images, liver tumors are difficult to distinguish from adjacent liver parenchyma because of signal isointensity (Figure 2B). Fat-suppressed post-Gd SGE imaging showed an almost homogenous signal (arrows) of moderately enhancing liver tumors (Figure 2C). Three weeks after onset of sorafenib therapy, nonenhanced T1WI imaging revealed multiple focal strongly hyperintense lesions (arrows) presumed to represent hemorrhagic necrosis in the known tumors (Figure 2D). Coronal HASTE images performed at the same time demonstrated also hyperintense signals (arrows) of tumors with a good delineation to adjacent liver parenchyma (Figure 2E). Fat-suppressed post-Gd SGE imaging showed central >75% necrosis in most of the HCC lesions following sorafenib therapy (Figure 2F).
Horger et al. BMC Cancer 2009 9:208 doi:10.1186/1471-2407-9-208