fig11

Figure 11. SBRT as a bridge to liver transplantation for HCC in a 55-year-old man with alcohol-related cirrhosis and Child-Pugh Class C liver function. A: Axial arterial phase CT image showed hyper enhancement of a 2 cm mass in the right hepatic lobe (arrowhead), accompanied by moderate ascites. Liver function was scored as Child-Pugh Class C; B: the patient underwent SBRT with a dose of 50 Gy in five fractions; C-E: Axial arterial phase MRI images 1.5 months (C), 5 months (D), and 9 months (E) after SBRT showed complete tumor response. However, focal reaction with enhancement indicated congestion of the hepatic parenchyma in the radiation field. The patient received a liver transplant 22 months after SBRT; F: axial arterial phase CT image one year after liver transplantation demonstrated a normal liver. SBRT: stereotactic body radiation therapy; HCC: hepatocellular carcinoma; MRI: magnetic resonance imaging; CT: computed tomography