Abstract

OBJECTIVE
To our knowledge there is currently no quantitative preprocedural method for predicting the distribution and selectivity of delivery of chemoembolic material during trans-arterial chemoembolization. Transcatheter intraarterial perfusion MRI has been developed as a method of quantifying hepatic arterial perfusion. The purpose of this study was to investigate whether findings at transcatheter intraarterial perfusion MRI before chemoembolization can be used to predict uptake of the chemoembolic material delivered during chemoembolization.
SUBJECTS AND METHODS
We compared quantitative prechemoembolization transcatheter intraarterial perfusion MRI parameters with analogous postchemoembolization CT chemoembolic distribution parameters and analyzed correlation using the Pearson correlation coefficient. These MRI and CT parameters included volume of distribution (a metric for volumetric liver perfusion or therapeutic agent delivery) and chemoembolic delivery selectivity factor (a ratio of volume-normalized tumor to background signal intensity that indicates the selectivity of chemoembolic delivery).
RESULTS
Twenty-four hepatocellular carcinomas were targeted in 18 patients (14 men, four women; mean age, 66 years), and segmental or lobar chemoembolization with intraprocedural transcatheter intraarterial perfusion MRI was successful in all 18. Transcatheter intraarterial perfusion MRI and CT volume of distribution did not differ significantly (MRI, 233 cm(3); CT, 235 cm(3); p = 0.857). Transcatheter intraarterial perfusion MRI selectivity factor was an underestimate of CT selectivity factor (MRI, 0.20; CT, 0.25; p = 0.005). Prechemoembolization transcatheter intraarterial perfusion MRI and postchemoembolization CT volume of distribution (r = 0.93; p < 0.001) and selectivity factor (r = 0.95; p < 0.001) showed significant correlation.
CONCLUSION
Tumor perfusion measured with transcatheter intraarterial perfusion MRI is predictive of uptake of chemoembolic material before delivery. This MRI technique may have utility as a method of quantifying delivery of the therapeutic agent during chemoembolization and, potentially, other liver-directed locoregional therapies.

Links

Publisher Full Text

Authors

Gaba RC, Jin B, Wang D, Lewandowski RJ, Ragin AB, Larson AC, Salem R, Omary RA

Institution

Department of Radiology, University of Illinois at Chicago, USA.

Source

AJR. American journal of roentgenology 198:5 2012 May pg 1196-202

MeSH

Aged
Carcinoma, Hepatocellular
Catheterization
Chemoembolization, Therapeutic
Cisplatin
Contrast Media
Doxorubicin
Ethiodized Oil
Female
Gadolinium DTPA
Humans
Image Interpretation, Computer-Assisted
Iohexol
Linear Models
Liver Neoplasms
Magnetic Resonance Angiography
Male
Microspheres
Mitomycin
Tomography, X-Ray Computed
Treatment Outcome

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

22528913