A-F. 61-year-old male patient with metastatic HCC (patient #17). Axial nonenhanced T1WI imaging of the liver showed hypointense signal of all HCC lesions (arrows) (Figure 3A). On corresponding T2WI images, HCC lesions demonstrated all a moderate hyperintense signal (arrows) compared to adjacent liver parenchyma (Figure 3B). Fat-suppressed post-Gd SGE imaging revealed a diffuse enhancement throughout all HCC lesions (arrows) with small central areas of necrosis (arrowhead) (Figure 3C). Five weeks after onset of sorafenib therapy, the signal of HCC lesions on T1WI- imaging increased (arrows) becoming iso- to hyperintense to adjacent liver parenchyma (Figure 3D). At this time, there was at best mild increase in tumor signal on fat-suppressed T2WI imaging (arrows) (Figure 3E). However, fat-suppressed post-Gd T1WI demonstrated >75% reduction of enhancing tumor areas due to necrosis (arrows) (Figure 3F).
Horger et al. BMC Cancer 2009 9:208 doi:10.1186/1471-2407-9-208