Fig. 5.

62-year-old male patient with left colon cancer and liver metastasis in segment 5 (arrows).

The upper row shows baseline contrast-enhanced CT (left) and MRI (centre T2-weighted and right ADC map). The lower row shows follow-up exams after 6 cycles of FOLFOX. On baseline, the lesion appears ill-defined and heterogeneous, with peripheral contrast uptake. After chemotherapy, the lesion is homogeneously hypoattenuating, with sharp border, and no peripheral contrast enhancement, thus corresponding to an ‘optimal response’ according to the MD Anderson criteria. It corresponds to a shift from baseline mild and heterogeneous signal hyperintensity to a homogeneous high signal intensity on T2-w images. ADC maps show a significant increase in the ADC values of the tumour under chemotherapy, also consistent with tumour response. ADC, apparent diffusion coefficient.