FOLLOW-UP
Follow-up typically includes a combination of imaging, tumor marker assay, and selective use of fine-needle aspiration and biology (FNAB).Following serial levels of AFP in the cases of HCC is useful only in cases in which the serum levels of this marker is elevated prior to the initiation of therapy. Random FNAB is subject to sampling error, such that it is only definitive if positive for malignancy. This fact, together with the reliability of CT in differentiating tumor necrosis from residual tumor, has led to FNAB being reserved for equivocal cases.
Figure 1-2 Below is a CT scan of a patient with two liver tumors (depicted by the arrows). The patient underwent an injection with DTI-0l5, which produced death of both tumors (depicted by the dark homogenous masses and two white arrows).
Figure 3 Chemoembolization, hepatic. Contrast-enhanced axial CT scan through the liver in the portal venous phase in an 88-year-old woman who presented with right upper quadrant discomfort. Scan shows a 13-cm mass occupying the right lobe of the liver; it displaces the portal vein medially. Results of laparoscopic biopsy confirmed the mass to be a well-differentiated hepatocellular carcinoma in a noncirrhotic liver. 
Figure 4 Chemoembolization, hepatic. Arterial/early capillary phase of a celiac-axis angiogram (same patient as in Image 3) shows extensive neovascularity in the mass, with stretching of the vessels around the mass.
Figure 5 Chemoembolization, hepatic. Portal venous phase of a celiac-axis angiogram (same patient as in Images 3-4) shows patent splenic and portal veins; therefore, the patient is a suitable candidate for chemoembolization. 
Figure 6 Chemoembolization, hepatic. Contrast-enhanced axial CT scan through the liver (same patient as in Images 3-5) obtained 10 days after chemoembolization shows intensely concentrated lipiodol within the hepatocellular carcinoma. Note the considerable central tumor necrosis.
Figure 7 Transverse CT scans obtained in a 71-year-old woman with HCC in the hepatic dome. (a) Early-phase scan obtained before PEI shows a 1.4-cm nodule (arrow) in the anterosuperior segment of the liver. (b) At CT fluoroscopy, two needles were inserted into the nodule with a right-sided approach, and 10 ml of absolute ethanol was injected. (c) Early-phase scan obtained 1 year after PEI shows no enhancement (arrowhead) in the tumor area.