PMC10017836_01
Abdominal magnetic resonance imaging (MRI) evaluation. (A) Abdominal MRI showing multiple intrahepatic lesions with a maximum diameter of approximately 5.7 cm. In the arterial phase before drug-eluting beads transarterial chemoembolization (DEB-TACE), multiple scattered abnormal vascular shadows could be seen in the right and left lobes of the liver (B). One month after embolization, digital subtraction angiography (DSA) showed a significant reduction in abnormal vascular shadows in the tumor (C).
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Multiple intrahepatic space-occupying lesions, with a maximum diameter of approximately 5.7 cm, were found by MRI (  Figure 1A  ). DEBIRI-TACE was performed in February 2020. During the operation, multiple scattered, abnormal vascular shadows were observed in both the right and left lobes of the liver (  Figure 1B  ). One month after embolization, digital subtraction angiography showed significantly smaller abnormal vascular shadows in the liver compared with the pre-treatment condition (  Figure 1C  ), and the CEA content had decreased to 64.21 ng/L.
Drug-eluting beads transarterial chemoembolization (DEB-TACE), fluorodeoxyglucose-positron emission tomography/computed tomography (FDG PET/CT) assessment. Six weeks after the second DEB-TACE, FDG PET/CT (A) showed that the SUVmax of liver flexure and transverse colon lesions was decreased from 13.2 to 7.2. The SUVmax of some right lobe lesions was decreased from 14.0 to 5.3 (B, C) red arrow). Re-examination of contrast-enhanced abdominal MRI showed that the intrahepatic tumor volume was not significantly reduced, and the sum of target lesion diameters was less than 30% compared with the baseline level (D).
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April 2020, FDG PET/CT (  Figure 2A  ) showed a local thickening of the wall at the hepatic flexure and transverse colon, a narrowing of the lumen, increased FDG uptake (a decrease in the maximum standardized uptake value [SUVmax] from 13.2 to 7.2) in liver flexure and transverse colon lesions, slightly increased FDG uptake (a decrease in the SUVmax from 14.0 to 5.3) in right lobe lesions ( Figures 2B, C  ), and a decrease in hilar lymph node enlargement (a decrease in the SUVmax from 13.8 to 3.6). According to PERCIST classification, the treatment response was evaluated as partial metabolic response (PMR). Some nodules and masses were slightly smaller compared with before treatment, and the sum of target lesion diameters was less than 30% of that of the baseline level (  Figure 2D  ).