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Figure 1c: Images in 69-year-old man with two HCC lesions involving both lobes of the liver. Both lesions were completely ablated after two doses of 188Re HDD iodized oil at three monthly intervals. At the time of this writing, the patient was alive and ambulatory with normal serum AFP levels and no evidence of a mass at 3-year follow-up CT. (a) Pretherapy transverse CT scan shows two lesions (arrows): One each in segments IV (subdiaphragmatic) and VIII. (b) Angiogram shows increased vascularity in both lesions (arrows). (c) Posttreatment 188Re whole-body scan shows radiotracer accumulation in the tumors (arrows), with faint visualization of lungs and no radiotracer uptake in the thyroid, gastrointestinal tract, or anywhere else. (d) Repeat transverse CT scan obtained 3 months after the second dose shows complete disappearance of both lesions (arrows). Small radioopaque area in segment IV lesion (appearing to be enhancing HCC mass in larger arterial phase image) is actually a small amount of iodized oil, which was seen in all CT scanning phases (noncontrast, arterial, portal venous, and delayed). (e) Positron emission tomography/CT scan obtained 2 years after treatment also shows no evidence of residual or recurrent disease (arrows). Inset images show segment IV lesion.
