TY - JOUR
T1 - Intraprocedural transcatheter intraarterial perfusion (Trip)-MRI for evaluation of irreversible electroporation therapy response in a rabbit liver tumor model
AU - Shangguan, Anna J.
AU - Zhou, Kang
AU - Yang, Jia
AU - Eresen, Aydin
AU - Wang, Bin
AU - Sun, Chong
AU - Pan, Liang
AU - Hu, Su
AU - Khan, Ali T.
AU - Mouli, Samdeep K.
AU - Yaghmai, Vahid
AU - Zhang, Zhuoli
N1 - Funding Information:
This study was supported by the National Cancer Institute (grants R01CA209886, R01CA196967, and R01CA241532), by 2019 Harold E. Eisenberg Foundation Scholar A ward, and by the Fishel Fellowship A ward at the Robert H. Lurie Comprehensive Cancer Center of Northwestern University , and by SIR Foundation Pilot Grant (PR-0000000012).
Publisher Copyright:
© 2020 Shangguan et al.
PY - 2020
Y1 - 2020
N2 - Purpose: Irreversible electroporation (IRE) is a promising new ablation method for hepa-tocellular carcinoma (HCC) treatment with few side-effects; however, tissue perfusion and differentiation between treatment zones have not been sufficiently studied. In this project, we analyzed HCC tumor perfusion changes immediately after IRE treatment using transcatheter intraarterial perfusion (TRIP)-MRI to monitor treatment zone margins. Materials and Methods: All protocols were approved by the institutional animal care and use committee. A total of 34 rabbits were used for this prospective study: tumor liver group (n=17), normal liver group (n=14), and 3 for growing VX2 tumors. All procedures and imaging were performed under anesthesia. VX2 tumors were grown by injection of VX2 cells into rabbit hindlimbs. Liver tumors were induced by percutaneous US-guided injection of VX2 tumor fragments into liver. For digital subtraction angiography (DSA), a 2F catheter was advanced through left hepatic artery via femoral artery access, followed by contrast injection. All rabbits underwent baseline anatomic MRI, then IRE procedure or IRE probe placement only, and lastly post-procedure anatomic and TRIP-MRI. Liver tissues were dissected immediately after imaging for histology. All statistical analyses were performed on GraphPad Prism, with P<0.05 considered significant. Results: IRE generated central IRE zone and peripheral reversible electroporation (RE) zone on anatomic MRI for both normal liver and liver tumor tissues. The semiquantitative analysis showed that IRE zone had the lowest AUC, PE, WIS, Ktrans, ve, and vp as well as the highest TTP, followed by RE zone, then untreated tissues. Receiver operating characteristic analysis showed that WIS and AUC60 had the highest AUCROC. Histologic analysis showed a positive correlation in viable area fraction between MRI and histologic measurements. IRE zone had the highest %apoptosis and lowest CD31+ staining. Conclusion: Our results demonstrated that intraprocedural TRIP-MRI can effectively differentiate IRE and RE zones after IRE ablation in normal liver and liver tumor tissues.
AB - Purpose: Irreversible electroporation (IRE) is a promising new ablation method for hepa-tocellular carcinoma (HCC) treatment with few side-effects; however, tissue perfusion and differentiation between treatment zones have not been sufficiently studied. In this project, we analyzed HCC tumor perfusion changes immediately after IRE treatment using transcatheter intraarterial perfusion (TRIP)-MRI to monitor treatment zone margins. Materials and Methods: All protocols were approved by the institutional animal care and use committee. A total of 34 rabbits were used for this prospective study: tumor liver group (n=17), normal liver group (n=14), and 3 for growing VX2 tumors. All procedures and imaging were performed under anesthesia. VX2 tumors were grown by injection of VX2 cells into rabbit hindlimbs. Liver tumors were induced by percutaneous US-guided injection of VX2 tumor fragments into liver. For digital subtraction angiography (DSA), a 2F catheter was advanced through left hepatic artery via femoral artery access, followed by contrast injection. All rabbits underwent baseline anatomic MRI, then IRE procedure or IRE probe placement only, and lastly post-procedure anatomic and TRIP-MRI. Liver tissues were dissected immediately after imaging for histology. All statistical analyses were performed on GraphPad Prism, with P<0.05 considered significant. Results: IRE generated central IRE zone and peripheral reversible electroporation (RE) zone on anatomic MRI for both normal liver and liver tumor tissues. The semiquantitative analysis showed that IRE zone had the lowest AUC, PE, WIS, Ktrans, ve, and vp as well as the highest TTP, followed by RE zone, then untreated tissues. Receiver operating characteristic analysis showed that WIS and AUC60 had the highest AUCROC. Histologic analysis showed a positive correlation in viable area fraction between MRI and histologic measurements. IRE zone had the highest %apoptosis and lowest CD31+ staining. Conclusion: Our results demonstrated that intraprocedural TRIP-MRI can effectively differentiate IRE and RE zones after IRE ablation in normal liver and liver tumor tissues.
KW - Hepatocellular carcinoma
KW - Irreversible electroporation
KW - Liver cancer
KW - Perfusion
KW - Transcatheter intraarterial perfusion magnetic resonance imaging
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U2 - 10.2147/CEG.S269163
DO - 10.2147/CEG.S269163
M3 - Article
C2 - 33192084
AN - SCOPUS:85097927457
SN - 1178-7023
VL - 13
SP - 543
EP - 553
JO - Clinical and Experimental Gastroenterology
JF - Clinical and Experimental Gastroenterology
ER -
