Page 500 - Read Online

Zeng et al. Hepatoma Res2020;6:43 I http://dx.doi.org/10.20517/2394-5079.2020.29 Page 7 of 12

A B C

D E F

G H I
Figure 6. SBRT for residual HCC after surgical resection in a 59-year-old man. A: Axial arterial phase MRI scan 6 years after initial surgery
showed a 2.1-cm recurrent hyper-enhancing nodule adjacent to the inferior vein cava, located in the second hepatic hilar segment. The
patient underwent TACE for the recurrent lesion; B: axial arterial phase CT image one month after TACE showed a hyper-enhancing
lesion (arrow), with no lipiodol deposition. Then, the patient underwent hepatic wedge resection in May 2011; C: axial arterial phase CT
image one month after surgery revealed residual tumor with hyper enhancement (arrow); D: the patient underwent SBRT with a dose of
50 Gy in five fractions in June 2011; E: axial arterial phase CT image 3 months after SBRT showed complete response of the target lesion;
F,G: Axial arterial (F) and portal venous phases (G) CT images 13 months after SBRT showed persistent enhancement of the radiation
field because of post-SBRT changes representing congestion and edema; H,I: Follow-up CT images 2 years (H) and 8 years (I) after
SBRT demonstrated a normal liver. SBRT: stereotactic body radiation therapy; HCC: hepatocellular carcinoma; MRI: magnetic resonance
imaging; TACE: transarterial chemoembolization; CT: computed tomography

A B

C

E D

Figure 7. SBRT for residual tumor after RFA in a 66-year-old man. A: Axial and sagittal MRI images approximately 1.5 months after RFA
showed a hepatic lesion with a residual cavity and viable tumor (arrowhead) close to the inferior vena cava; B: the patient underwent
SBRT with a dose of 50 Gy in 10 fractions for the residual tumor; C-E: MRI images obtained 6 months (C), 1 year (D), and 4 years
(E) after SBRT illustrate gradual shrinkage and eventual disappearance of the tumor. SBRT: stereotactic body radiation therapy; RFA:
radiofrequency ablation; MRI: magnetic resonance imaging