Quantitative 4D transcatheter intraarterial perfusion MRI for monitoring chemoembolization of hepatocellular carcinoma

Dingxin Wang, Brian Jin, Robert J. Lewandowski, Robert K. Ryu, Kent T. Sato, Mary F. Mulcahy, Laura M. Kulik, Frank H. Miller, Riad Salem, Debiao Li, Reed A. Omary, Andrew C. Larson

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Abstract

Purpose: To develop a fully quantitative 4D transcatheter intraarterial perfusion (TRIP) magnetic resonance imaging (MRI) technique and prospectively test the hypothesis that quantitative 4D TRIP-MRI can be used clinically to monitor intraprocedural liver tumor perfusion reductions during transcatheter arterial chemoembolization (TACE). Materials and Methods: TACE was performed within an x-ray digital subtraction angiography (DSA)-MRI procedure suite in 16 patients with hepatocellular carcinoma. Quantitative 4D TRIP-MRI with targeted radiofrequency field mapping and dynamic longitudinal relaxation rate mapping was used to monitor changes in tumor perfusion during TACE. First-pass perfusion analysis was performed to produce intraprocedural blood flow (Fρ) maps. Mean liver tumor perfusions before and after TACE were compared with a paired t-test (α = 0.05). Results: Perfusion reductions were successfully measured with quantitative 4D TRIP-MRI in 22 separate tumors during 18 treatment sessions. Mean tumor perfusion Fρ decreased from 16.3 (95% confidence interval [CI]: 10.7-21.9) before TACE to 5.0 (95% CI: 3.5-6.5) (mL/ min/100 mL) after TACE. Tumor perfusion reductions were statistically significant (P < 0.0005), with a mean absolute perfusion change of 11.4 (95% CI: 5.6-17.1) (mL/min/100 mL) and a mean percentage reduction of 61.0% (95% CI: 48.3%-73.6%). Conclusion: Quantitative 4D TRIP-MRI can be successfully performed within clinical interventional settings to monitor intraprocedural changes in liver tumor perfusion during TACE.

Original languageEnglish (US)
Pages (from-to)1106-1116
Number of pages11
JournalJournal of Magnetic Resonance Imaging
Volume31
Issue number5
DOIs
StatePublished - May 1 2010

Fingerprint

Magnetic Resonance Angiography
Hepatocellular Carcinoma
Perfusion
Neoplasms
Confidence Intervals
Liver
Digital Subtraction Angiography
Magnetic Resonance Imaging
X-Rays

Keywords

  • Hepatocellular carcinoma
  • Liver tumor
  • Perfusion
  • Quantitative imaging
  • TACE
  • TRIP-MRI

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

@article{839966e3a7d642cd842aea8956069222,
title = "Quantitative 4D transcatheter intraarterial perfusion MRI for monitoring chemoembolization of hepatocellular carcinoma",
abstract = "Purpose: To develop a fully quantitative 4D transcatheter intraarterial perfusion (TRIP) magnetic resonance imaging (MRI) technique and prospectively test the hypothesis that quantitative 4D TRIP-MRI can be used clinically to monitor intraprocedural liver tumor perfusion reductions during transcatheter arterial chemoembolization (TACE). Materials and Methods: TACE was performed within an x-ray digital subtraction angiography (DSA)-MRI procedure suite in 16 patients with hepatocellular carcinoma. Quantitative 4D TRIP-MRI with targeted radiofrequency field mapping and dynamic longitudinal relaxation rate mapping was used to monitor changes in tumor perfusion during TACE. First-pass perfusion analysis was performed to produce intraprocedural blood flow (Fρ) maps. Mean liver tumor perfusions before and after TACE were compared with a paired t-test (α = 0.05). Results: Perfusion reductions were successfully measured with quantitative 4D TRIP-MRI in 22 separate tumors during 18 treatment sessions. Mean tumor perfusion Fρ decreased from 16.3 (95{\%} confidence interval [CI]: 10.7-21.9) before TACE to 5.0 (95{\%} CI: 3.5-6.5) (mL/ min/100 mL) after TACE. Tumor perfusion reductions were statistically significant (P < 0.0005), with a mean absolute perfusion change of 11.4 (95{\%} CI: 5.6-17.1) (mL/min/100 mL) and a mean percentage reduction of 61.0{\%} (95{\%} CI: 48.3{\%}-73.6{\%}). Conclusion: Quantitative 4D TRIP-MRI can be successfully performed within clinical interventional settings to monitor intraprocedural changes in liver tumor perfusion during TACE.",
keywords = "Hepatocellular carcinoma, Liver tumor, Perfusion, Quantitative imaging, TACE, TRIP-MRI",
author = "Dingxin Wang and Brian Jin and Lewandowski, {Robert J.} and Ryu, {Robert K.} and Sato, {Kent T.} and Mulcahy, {Mary F.} and Kulik, {Laura M.} and Miller, {Frank H.} and Riad Salem and Debiao Li and Omary, {Reed A.} and Larson, {Andrew C.}",
year = "2010",
month = "5",
day = "1",
doi = "10.1002/jmri.22155",
language = "English (US)",
volume = "31",
pages = "1106--1116",
journal = "Journal of Magnetic Resonance Imaging",
issn = "1053-1807",
publisher = "John Wiley and Sons Inc.",
number = "5",

}

TY - JOUR

T1 - Quantitative 4D transcatheter intraarterial perfusion MRI for monitoring chemoembolization of hepatocellular carcinoma

AU - Wang, Dingxin

AU - Jin, Brian

AU - Lewandowski, Robert J.

AU - Ryu, Robert K.

AU - Sato, Kent T.

AU - Mulcahy, Mary F.

AU - Kulik, Laura M.

AU - Miller, Frank H.

AU - Salem, Riad

AU - Li, Debiao

AU - Omary, Reed A.

AU - Larson, Andrew C.

PY - 2010/5/1

Y1 - 2010/5/1

N2 - Purpose: To develop a fully quantitative 4D transcatheter intraarterial perfusion (TRIP) magnetic resonance imaging (MRI) technique and prospectively test the hypothesis that quantitative 4D TRIP-MRI can be used clinically to monitor intraprocedural liver tumor perfusion reductions during transcatheter arterial chemoembolization (TACE). Materials and Methods: TACE was performed within an x-ray digital subtraction angiography (DSA)-MRI procedure suite in 16 patients with hepatocellular carcinoma. Quantitative 4D TRIP-MRI with targeted radiofrequency field mapping and dynamic longitudinal relaxation rate mapping was used to monitor changes in tumor perfusion during TACE. First-pass perfusion analysis was performed to produce intraprocedural blood flow (Fρ) maps. Mean liver tumor perfusions before and after TACE were compared with a paired t-test (α = 0.05). Results: Perfusion reductions were successfully measured with quantitative 4D TRIP-MRI in 22 separate tumors during 18 treatment sessions. Mean tumor perfusion Fρ decreased from 16.3 (95% confidence interval [CI]: 10.7-21.9) before TACE to 5.0 (95% CI: 3.5-6.5) (mL/ min/100 mL) after TACE. Tumor perfusion reductions were statistically significant (P < 0.0005), with a mean absolute perfusion change of 11.4 (95% CI: 5.6-17.1) (mL/min/100 mL) and a mean percentage reduction of 61.0% (95% CI: 48.3%-73.6%). Conclusion: Quantitative 4D TRIP-MRI can be successfully performed within clinical interventional settings to monitor intraprocedural changes in liver tumor perfusion during TACE.

AB - Purpose: To develop a fully quantitative 4D transcatheter intraarterial perfusion (TRIP) magnetic resonance imaging (MRI) technique and prospectively test the hypothesis that quantitative 4D TRIP-MRI can be used clinically to monitor intraprocedural liver tumor perfusion reductions during transcatheter arterial chemoembolization (TACE). Materials and Methods: TACE was performed within an x-ray digital subtraction angiography (DSA)-MRI procedure suite in 16 patients with hepatocellular carcinoma. Quantitative 4D TRIP-MRI with targeted radiofrequency field mapping and dynamic longitudinal relaxation rate mapping was used to monitor changes in tumor perfusion during TACE. First-pass perfusion analysis was performed to produce intraprocedural blood flow (Fρ) maps. Mean liver tumor perfusions before and after TACE were compared with a paired t-test (α = 0.05). Results: Perfusion reductions were successfully measured with quantitative 4D TRIP-MRI in 22 separate tumors during 18 treatment sessions. Mean tumor perfusion Fρ decreased from 16.3 (95% confidence interval [CI]: 10.7-21.9) before TACE to 5.0 (95% CI: 3.5-6.5) (mL/ min/100 mL) after TACE. Tumor perfusion reductions were statistically significant (P < 0.0005), with a mean absolute perfusion change of 11.4 (95% CI: 5.6-17.1) (mL/min/100 mL) and a mean percentage reduction of 61.0% (95% CI: 48.3%-73.6%). Conclusion: Quantitative 4D TRIP-MRI can be successfully performed within clinical interventional settings to monitor intraprocedural changes in liver tumor perfusion during TACE.

KW - Hepatocellular carcinoma

KW - Liver tumor

KW - Perfusion

KW - Quantitative imaging

KW - TACE

KW - TRIP-MRI

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DO - 10.1002/jmri.22155

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