Fig. 1

WBMRI better characterising diffuse liver disease. 43-year-old female with patient with ER- PR- positive HER-2 negative metastatic breast cancer to the nodes, lung and liver was being monitored with CT during chemotherapy treatment. Follow up CT following 3 cycles demonstrates enlarging and more confluent liver lesion at the liver dome (C – yellow arrow) compared to prior CT (A—yellow arrow) and a greater number of lesions elsewhere within the liver suggesting worsening disease (D) when compared to prior CT (B) however tumour markers were improving on treatment. The increasingly irregular liver contour suggests pseudocirrhosis (D). WBMRI was performed to further evaluate the CT findings. The high b value (b900) DWI images (E) and corresponding ADC map (F) show diffuse disease with some lesions demonstrating high ADC values representing low cellularity/treated disease and others demonstrating low ADC values representing high cellularity/active disease in keeping with a mixture of treated and active disease, indicating a favourable response to treatment in some areas