Figure 8b:

Images show perfusion CT enabling prediction of early treatment response after chemotherapy for liver metastases from sigmoid colon cancer. (a) Baseline CT perfusion image of liver before chemotherapy shows large, 6.2-cm low-attenuating mass (arrow) at dome of liver. Liver metastases show decreased blood flow (BF) (top middle), blood volume (BV) (top right), and permeability (bottom left) and increased HPI (bottom middle) compared with adjacent normal parenchyma. (b) On perfusion CT scan after one cycle cytotoxic chemotherapy with capecitabine and oxaloplatin, tumor does not show change in size or attenuation (top left), indicating no response to chemotherapy based on RECIST. However, substantial decrease in perfusion parameters suggests tumor response. (c) Three cycles of chemotherapy later, CT findings confirmed partial response based on RECIST with a marked decrease (6.2 to 2.9 cm) in tumor size. MIP = maximum intensity projection.