Fig. 1
64-year-old male patient with 2.5 cm large HCC in liver segment 8 (arrows). Maximum intensity projection (a) and perfusion-CT (PCT) blood flow (b), blood volume (c) and arterial liver perfusion (d) color-coded maps are shown. Signal intensity on unenhanced fat-saturated (fs) T1w (e) is hyperintense with typical wash-in enhancement pattern on post-contrast fs T1w in the arterial (f), phase. No contrast wash-out is seen in the late post-contrast phase (g) whereas in the hepatobiliary (h) phase the tumor stays isointense to the background liver parenchyma. The tumor was hyperintense on T2w (not shown) including DWI (i, T2-shine through effect), but there was no restriction of water diffusivity. Calculated ERa was 117.8. On PCT the HPI was 100%, BFmax = 250.9 mL/100 g tissue; BV = 13.1 mL/100 g tissue; ALP = 35.3 mL/100 g tissue. Notably, despite exclusive arterial supply of the histologically proven tumor, there was no wash-out in the late venous phase (h) and also poor delineation of the tumor in the hepatobiliary phase (g)