Fig. 2

60 years old male patient underwent TACE. PET/CT uptake and diffusion restriction in TR-LR viable lesion with tumoral right portal vein thrombosis. A, B MRI T2 WI showing hypointense necrotic ablated lesion (red arrow) with medial hyperintense lesion (green arrow) and wedge-shaped hyperintense area in hepatic sub-segment VI (yellow arrow). C–F arterial (C, D), and delayed (E, F) DCE MRI showing the necrotic ablated non-enhancing area (red arrow), residual viable HCC (green arrow) which shows APHE and washout, the right portal vein branch is occluded with tumoral thrombus. A persistent enhancing subsegment VI wedge-shaped lesion in the arterial and delayed phase (yellow arrow) is seen and it corresponds to transient hepatic attenuation differences (THAD). G, H DWI (G) and ADC map (H) the lesion is hyperintense in the DWI with low ADC value compared to the adjacent liver, the mean ADC of the portal vein lesion is 1.1 × 10⁻³ mm²/s. I–L axial PET/CT fused images showing necrotic lesion with SUV max measuring 1.45 (I), residual non ablated HCC with increased FDG uptake (J) and involvement of the right portal vein branch (K), the SUV max measures 5.62 and 5.99 in the viable HCC and the tumoral portal vein lesion respectively. No focal uptake was seen in the hepatic sub-segment VI THAD area with SUV max measuring 3.3 (L)