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Published online 2012 December. doi: 10.1148/radiol.12120226

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HCC in a 65-year-old man shows hypointensity on hepatobiliary phase gadoxetic acid–enhanced MR images (serum AFP level, 13 700 ng/mL [13 700 μg/L]; AFP-L3, 48.7%; and PIVKA-II, 7924 mAU/mL). (a) On hepatobiliary phase images (obtained 20 minutes after injection of gadoxetic acid), 42-mm tumor (arrow) shows lower SI than that of background liver (tumor SI/background SI = 0.51). (b) Photomicrograph of hematoxylin and eosin stained slide shows moderately differentiated HCC with trabecular proliferation pattern. (c) At immunohistochemical evaluation (magnification, ×200), tumor shows no expression of OATP8, but (d) intense expression of both AFP (brown color) and (e) PIVKA-II (brown color).

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