fig1

Figure 1. HCC with vascular invasion: 67 years-old female with HCV viral cirrhosis, Child A6, MELD 9. (A-C) CT scan in arterial (A), portal (B) and delayed (C) phases shows ill defined HCC (diameter about 4 cm) in segment VIII with infiltrative growth and portal vein branch tumor thrombosis. (D) Selective right lobe DSA before the first DSM TACE demonstrating multiple small hypervascular areas. (E) Angiography after 4 weeks before the second DSM-TACE treatment shows good tumor response to chemotherapy with contrast blush disappearance and patency of the hepatic artery with irregularities of the distal branches due to chemical vasculitis. (F) Follow-up CT at 5 years: complete tumor response without recurrence in the arterial phase.