Fig. 1

Pre- and posttreatment images of case 2. On the arterial phase of the pretreatment MRI, a hypervascular lesion in segment 8 is depicted on a background of liver cirrhosis, consistent with a HCC (a). Pretreatment hepatobiliary scintigraphy shows a visually fairly homogenous ^99mTc-mebrofenin uptake with a defect in segment 8, corresponding to the HCC (b). Posttreatment ⁹⁰Y-PET/CT shows good targeting of the HCC (227 Gy), but also a significant ⁹⁰Y deposition in segment 7 (91 Gy) (c). At treatment angiography, the endhole catheter tip was positioned at the bifurcation of the anterior and posterior right hepatic artery. The overdosage of the posterior sector is therefore most likely due to preferential flow (d). Posttreatment MRI and hepatobiliary scintigraphy show ascites and shrinkage of the cirrhotic liver with increased arterial enhancement of the treated lobe and decreased ^99mTc-mebrofenin uptake (e, f)