Fig. 3. Unsuccessful identification of a tumor-feeder of hepatocellular carcinoma (HCC) in the Spiegel lobe (SP). (A) Hepatobiliary phase of gadoxetate disodium-enhanced magnetic resonance imaging showed HCC of 27 mm in diameter in SP (arrow). (B) Celiac arteriogram showed tumor staining (arrow); however, the tumor-feeder could not be identified. (C) Automated tumor-feeder detection identified the tumor-feeder arising from the common hepatic artery; however, it was considered a pseudo-feeder that was created by artifacts from contrast material. (D) Right hepatic arteriogram showed the tumor staining (arrow) and tumor-feeding caudate artery arising from the distal right hepatic artery (arrowhead). (E) The feeder was selectively embolized until the portal vein was opacified with iodized oil. The arrow indicates the tumor, and the arrowhead indicates the previously embolized tumor. (F) Unenhanced CT performed 1 week after TACE showed dense iodized oil accumulation in the tumor. (G) Arterial-phase CT performed 7 months after TACE showed that the tumor has remained well-controlled.
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