Figure 4c:

Multiple different MRI appearances seen after transarterial chemoembolization (TACE) therapy of hepatocellular carcinoma (HCC) (arrow in a and d) in three different patients (b and c in the same patient). (a) Axial T1-weighted postcontrast fat-suppressed image 1 month after TACE therapy shows a smooth continuous rim of arterial phase hyperenhancement (APHE), an expected posttreatment finding. There was no central APHE, consistent with treated tumor (mRECIST CR, LR-TR nonviable). (b) Axial T2-weighted image 1 month after TACE therapy shows high signal with a fluid-fluid level (arrow in b and c) within the treatment cavity with corresponding T1 precontrast hypointense signal (c), compatible with TACE liquefaction necrosis after treatment. Additionally, the lesion has areas of T2 hypointense signal (_* in b) and T1 hyperintense signal (_* in c) in other areas of the treated lesion. (d) Axial T1-weighted precontrast fat-suppressed image 1 month after TACE shows intrinsic hyperintense signal in the treated lesion, which did not enhance (confirmed on subtraction images, not shown), thus consistent with nonviable treated HCC. CR = complete response, LR = LI-RADS, mRECIST = modified Response Evaluation Criteria for Solid Tumors, TR = treatment response.