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. Author manuscript; available in PMC: 2019 Nov 15.

Published in final edited form as: Int J Radiat Oncol Biol Phys. 2017 Aug 24;102(4):1063–1069. doi: 10.1016/j.ijrobp.2017.08.022

Fig. 2 — A 55-year-old man with hepatitis C–related cirrhosis and a 4.6-cm Organ Procurement and Transplantation Network 5b hepatocellular carcinoma in segment 7 of the liver (subject 4). Imaging is T1-weighted fat-saturated ultrafast spoiled gradient echo imaging in the axial plane before stereotactic body radiation therapy (SBRT) (a, b) and at multiple time points after SBRT (c, d: 3 months; e, f: 6 months; g, h: 12 months). Arterial (a) and portal venous (b) phase images before SBRT show an arterial enhancing lesion with wash-out. Three months after SBRT, arterial (c) and portal venous (d) phase images show persistent arterial enhancement with persistent wash-out; however, the tumor has decreased in size, measuring 3.5 cm. In addition there is surrounding regional arterial phase enhancement of the parenchyma, which normalizes on the portal venous phase. Six months after SBRT, arterial (e) and portal venous (f) phase images show decreasing but persistent central arterial enhancement with persistent wash-out; however, the tumor has decreased in size, measuring 3.4 cm. The surrounding geographic arterial phase hyperenhancement is resolving. One year after SBRT, arterial (g) and portal venous (h) phase images show persistent central arterial enhancement with persistent wash-out; however, the tumor continues to decrease in size, measuring 3.2 cm. There is regional delayed enhancement (h), with progressive off-target parenchymal volume loss.

Fig. 2 — A 55-year-old man with hepatitis C–related cirrhosis and a 4.6-cm Organ Procurement and Transplantation Network 5b hepatocellular carcinoma in segment 7 of the liver (subject 4). Imaging is T1-weighted fat-saturated ultrafast spoiled gradient echo imaging in the axial plane before stereotactic body radiation therapy (SBRT) (a, b) and at multiple time points after SBRT (c, d: 3 months; e, f: 6 months; g, h: 12 months). Arterial (a) and portal venous (b) phase images before SBRT show an arterial enhancing lesion with wash-out. Three months after SBRT, arterial (c) and portal venous (d) phase images show persistent arterial enhancement with persistent wash-out; however, the tumor has decreased in size, measuring 3.5 cm. In addition there is surrounding regional arterial phase enhancement of the parenchyma, which normalizes on the portal venous phase. Six months after SBRT, arterial (e) and portal venous (f) phase images show decreasing but persistent central arterial enhancement with persistent wash-out; however, the tumor has decreased in size, measuring 3.4 cm. The surrounding geographic arterial phase hyperenhancement is resolving. One year after SBRT, arterial (g) and portal venous (h) phase images show persistent central arterial enhancement with persistent wash-out; however, the tumor continues to decrease in size, measuring 3.2 cm. There is regional delayed enhancement (h), with progressive off-target parenchymal volume loss.