Fig. 2
A 69-year-old female patient with a history of segment VI HCC, had both RFA and ethanol injection. TR-LR viable lesion with increased FDG uptake and diffusion restriction, also had active metastatic cervical lymph node, with two de novo hepatic lesions. MIP image (A) showing focal hepatic right lobar lower segmental increased tracer uptake (horizontal black arrow), two left lobar upper segmental small nodular tracer uptake (vertical blue arrows), and lower neck focal increased nodular uptake. Arterial (B) and portovenous (C) triphasic CT show residual/recurrent viable tumoral tissue (white arrow) shows APHE and washout. DWI (D) and ADC map (E) shows restricted diffusion in the ablated HCC (white arrow) with mean ADC value measuring 949 mm2/s. Fused PET/CT images show increased FDG uptake in the ablated HCC (red circle) achieving SUVmax of 7.1 (F) and focal increased FDG uptake in a right lower deep cervical lymph node (white arrow) (G). De novo two small hepatic left lobar lesions with restricted diffusion are noted at the DW MR axial images (H and I)