Role of gadoxetic acid-enhanced liver magnetic resonance imaging in the evaluation of hepatocellular carcinoma after locoregional treatment

Figure 9 Four-months follow-up post stereotactic body radiation therapy liver magnetic resonance imaging of the hepatocellular carcinoma in segment VIII shown in the Figure 8. A: Non contrast T1-weighted high resolution isotropic volume examination; B: T2-weighted image; C: T2-spectral attenuated inversion recovery; D: High b-value diffusion weighted imaging (DWI); E: Apparent diffusion coefficient (ADC) map; F: Arterial phase magnetic resonance imaging (MRI); G: Arterial phase MRI with image subtraction technique; H: Portal venous phase MRI; I: Delayed phase MRI; J: Hepatobiliary phase MRI. The liver MRI shows an ill-defined area of signal hypointensity in T1 in the treatment zone with a blurred and inhomogeneous signal hyperintensity with evidence of increased signal hyperintensity in the residual nodule. A shaded signal hyperintensity on DWI without signal hyperintensity of the previous lesion, with higher ADC values relative to the surrounding liver parenchyma. No areas of enhancement are shown, and a coarse hypointense signal in the hepatobiliary phase due to the initial fibrotic evolution of the treated zone is evident.