case_images: PMC10907002_01
case_images: Imaging liver tumors before RFA. T2-weighted (a), arterial phase (b), portal phase (c), hepatocellular phase (d), and diffusion-weighted image (e) of Gd-EOB-DTPA-MRI; CT during arterial portography (CTAP) (f), CT during hepatic arteriography (CTHA) early phase (g), CTHA late phase (h).
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case_images: F1
case_images: Gadolinium-ethoxybenzyl-diethylenetriamine penta-acetic acid-enhanced MRI (Gd-EOB-DTPA-MRI; EOB-MRI) showed a 16-mm lesion in hepatic S8 with high signal intensity in the arterial phase, washout from the portal venous phase, low signal in the hepatocellular phase, and high signal on diffusion-weighted images (Fig. 1a-e). CT during arterial portography (CTAP) showed no contrast of the mass (Fig. 1f). CT during hepatic arteriography (CTHA) showed that the mass was entirely contrasted in the early phase and had a coronal-like enhancement in the late phase (Fig. 1g, h).
case_images: Progress from the initial visit to our hospital. PIVKA-II tended to be slightly elevated at the time of the appearance of the HCC pulmonary metastasis. FDG-PET/CT showed FDG uptake in the lung tumor, but there were no other findings implicating malignancy. Three years after lung surgery, there was no evidence of recurrence.
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case_images: F2
case_images: However, although the same imaging 13 months later still showed no intrahepatic recurrence, a 26-mm lesion was observed in the right lower lung (Fig. 2).
case_images: Imaging of the lung mass appearing 13 months after RFA. T2-weighted (a), arterial phase (b), portal phase (c), and diffusion-weighted image (d) of Gd-EOB-DTPA-MRI; plain CT (e).
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case_images: F3
case_images: During the initial stage of imaging, use of a contrast agent revealed that the mass exhibited a prominent and intense signal on diffusion-weighted images (Fig. 3a-d). CT showed a single nodular lesion of 26 mm in S10 of the right lung (Fig. 3e).