Fig. 4

Technical failure of anatomical radiofrequency ablation in a 60-year-old man with a 2.0-cm hepatocellular carcinoma (HCC) and hepatitis B-related cirrhosis. (A) Hepatobiliary phase image of gadoxetic acid enhanced MRI shows a 2.0-cm low signal intensity HCC in segment VIII of the liver (large arrow). The 4th order portal vein branch close to the medial border of the tumor is visualized (small arrows). (B) Portal venous phase coronal reformatted image of immediate CT scan shows an insufficient medial safety margin (< 5 mm). Ablation of the 4th order portal vein branch (arrows) located near the medial border of the tumor had failed. (C) Arterial phase coronal reformatted image of 6-month follow-up CT shows a recurrent tumor with arterial enhancement at the medial aspect of the ablation defect (arrow). (D) Portal venous phase coronal reformatted image of 6-month follow-up CT shows a connection between the recurrent tumor (large arrow) and remnant 4th order portal vein branch (small arrows), which was not ablated