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. 2020 Dec 3;31(6):4367–4376. doi: 10.1007/s00330-020-07511-3

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© The Author(s) 2020

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

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Fig. 2 — a Screenshot of a manually segmented HCC lesion according to mRECIST criteria on baseline arterial phase imaging in mint Lesion™ 3.0 software with automatic generation of gray-level histograms and extraction of CT texture parameters. Favorable lesion size and parameters from CT texture analysis (especially mean of positive pixels (MPP) and uniformity) render this HCC lesion likely to respond completely to transcatheter arterial chemoembolization (TACE) treatment. b Four weeks after TACE treatment, the HCC shows no enhancement in arterial phase (thus, no viability) resulting in complete response as per mRECIST criteria. c Another manually segmented HCC lesion at baseline imaging. Unfavorable lesion size, surrounding liver parenchyma (cirrhotic), and parameters from CT texture analysis (especially MPP and uniformity) at baseline imaging result in a low likelihood of complete response to TACE treatment. d Follow-up imaging 4 weeks after TACE treatment shows substantial residual arterial enhancement (= viable portions of the tumor), resulting in partial response as per mRECIST criteria. The patient subsequently underwent repeated TACE, and the post-treatment CT images were used as new baseline