An 80-year-old male patient, suffering from liver cirrhosis and chronic hepatitis B, was diagnosed with hepatocellular carcinoma (HCC) and underwent transarterial chemoembolization (TACE) in 2010. Due to his chronic renal damage (the estimated glomerular filtration rate was 28–35 mL/min/1.73 m2), noncontrast CT or MRI had been performed for post-TACE follow-ups. In the last CT examination, a low attenuation lesion adjacent to the previous TACE site was visualized, raising the suspicion of a HCC recurrence. Considering his renal function insufficiency, a contrast-enhanced CT (CECT) scan was performed using a contrast agent with lower concentration (180 mgI/mL) and 70 kV setting. MRI was not performed due to anticipated patient’s intolerability of the examination time.