Figure 5a:

Imaging findings seen after transarterial chemoembolization (TACE) therapy with residual disease. Axial images from a 59-year-old woman with LR 5/OPTN 5B hepatocellular carcinoma (arrow). (a) A 3.8-cm arterial phase hyperenhancement hepatocellular carcinoma with washout (b) at pretreatment imaging. (c) Noncontrast CT image confirms ethiodized oil within the entire volume of tumor at immediate posttreatment imaging. (d) One month after TACE, the treatment cavity was unchanged in size, with loss of signal on the out-of-phase images, when compared with in-phase images (e). (f) Arterial phase postcontrast images 1 month after TACE demonstrate peripheral nodular enhancement, with washout (not shown), confirmed on subtraction images, with some central areas of necrosis (_*), compatible with residual disease (mRECIST PR, LR-TR viable). LR = LI-RADS, mRECIST = modified Response Evaluation Criteria for Solid Tumors, OPTN = Organ Procurement and Transplantation Network, PR = partial response, PV = portal venous, TR = treatment response.