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Figure 5. SBRT for HCC consisting of an extensive fat-tissue component in a 41-year-old man with Child-Pugh Class C liver function. A: Axial arterial phase CT image showed a 2-cm nodule containing fat attenuation (arrow). Mild ascites and splenomegaly were also evident; B: multiphasic CT images six months after liver protecting treatment demonstrated enlargement of the lesion to 3 cm (arrow), with enhancement in the arterial phase and washout in the portal venous phase. The patient was diagnosed with HCC with an extensive fat-tissue component. The ascites had disappeared, but splenomegaly was still present; C: the patient underwent SBRT with a dose of 54 Gy in six fractions; D: axial arterial phase CT image two months after SBRT showed the lesion (arrow) with a stable size and partial devascularization; E-G: axial arterial phase CT images 6 months (E), 9 months (F), and 13 months (G) after SBRT demonstrated progressive reduction in tumor size and devascularization of the lesion, consistent with a partial response based on mRECIST criteria; H: axial arterial phase CT image 25 months after SBRT showed complete response of the treated lesion, with marked focal atrophy of the irradiated hepatic parenchyma. SBRT: stereotactic body radiation therapy; HCC: hepatocellular carcinoma; CT: computed tomography; mRECIST: modified Response Evaluation Criteria In Solid Tumor