Transcatheter intraarterial perfusion: MR monitoring of chemoembolization for hepatocellular carcinoma - Feasibility of initial clinical translation

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Abstract

Purpose: To prospectively test the hypothesis that intraprocedural transcatheter intraarterial perfusion (TRIP) magnetic resonance (MR) imaging can be used to successfully measure reductions in perfusion to the targeted hepatocellular carcinoma (HCC) and the adjacent surrounding liver tissue during MR-interventional radiology (IR)-monitored transcatheter arterial chemoembolization (TACE). Materials and Methods: This HIPAA-compliant prospective study was approved by the institutional review board. An MR-IR unit was used to perform TACE in 10 patients with HCC (seven male, three female; eight younger than 69 years, two older than 69 years). Intraprocedural reductions in tumor perfusion before and after TACE were monitored with TRIP MR imaging. Time-signal intensity curves were derived, and semiquantitative spatially resolved area under the time-signal intensity curve maps of tumor perfusion before and after TACE were produced. Mean perfusion values before and after TACE for liver tumors and adjacent liver tissue were compared by using a mixed-model analysis, with α = .05. Results: Perfusion reductions were measured successfully with TRIP MR imaging in 18 separate tumors during 13 treatment sessions. Perfusion maps showed significant perfusion reductions for tumors (P < .013) but not for adjacent nontumorous liver tissue (P = .21). For tumors, the mean perfusion value was 193 arbitrary units (AU) ± 223 (standard deviation) before TACE and 45.3 AU ± 91.9 after TACE, with a mean reduction in baseline perfusion of 74.6% ± 24.8. For adjacent liver tissue, the mean perfusion value was 124 AU ± 93.5 before TACE and 93.2 AU ± 72.3 after TACE, with a mean reduction in baseline perfusion of 24.2% ± 14.5. Conclusion: TRIP MR imaging can be used to detect intraprocedural changes in perfusion to HCC and surrounding liver parenchyma during MR-IR-monitored TACE.

Original languageEnglish (US)
Pages (from-to)964-971
Number of pages8
JournalRadiology
Volume246
Issue number3
DOIs
StatePublished - Mar 1 2008

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Hepatocellular Carcinoma
Magnetic Resonance Spectroscopy
Perfusion
Magnetic Resonance Angiography
Interventional Radiology
Liver
Neoplasms
Health Insurance Portability and Accountability Act
Research Ethics Committees
Prospective Studies

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

@article{d424ab6d35de401eba13b548e692ef64,
title = "Transcatheter intraarterial perfusion: MR monitoring of chemoembolization for hepatocellular carcinoma - Feasibility of initial clinical translation",
abstract = "Purpose: To prospectively test the hypothesis that intraprocedural transcatheter intraarterial perfusion (TRIP) magnetic resonance (MR) imaging can be used to successfully measure reductions in perfusion to the targeted hepatocellular carcinoma (HCC) and the adjacent surrounding liver tissue during MR-interventional radiology (IR)-monitored transcatheter arterial chemoembolization (TACE). Materials and Methods: This HIPAA-compliant prospective study was approved by the institutional review board. An MR-IR unit was used to perform TACE in 10 patients with HCC (seven male, three female; eight younger than 69 years, two older than 69 years). Intraprocedural reductions in tumor perfusion before and after TACE were monitored with TRIP MR imaging. Time-signal intensity curves were derived, and semiquantitative spatially resolved area under the time-signal intensity curve maps of tumor perfusion before and after TACE were produced. Mean perfusion values before and after TACE for liver tumors and adjacent liver tissue were compared by using a mixed-model analysis, with α = .05. Results: Perfusion reductions were measured successfully with TRIP MR imaging in 18 separate tumors during 13 treatment sessions. Perfusion maps showed significant perfusion reductions for tumors (P < .013) but not for adjacent nontumorous liver tissue (P = .21). For tumors, the mean perfusion value was 193 arbitrary units (AU) ± 223 (standard deviation) before TACE and 45.3 AU ± 91.9 after TACE, with a mean reduction in baseline perfusion of 74.6{\%} ± 24.8. For adjacent liver tissue, the mean perfusion value was 124 AU ± 93.5 before TACE and 93.2 AU ± 72.3 after TACE, with a mean reduction in baseline perfusion of 24.2{\%} ± 14.5. Conclusion: TRIP MR imaging can be used to detect intraprocedural changes in perfusion to HCC and surrounding liver parenchyma during MR-IR-monitored TACE.",
author = "Larson, {Andrew C.} and Dingxin Wang and Bassel Atassi and Sato, {Kent T.} and Ryu, {Robert K.} and Lewandowski, {Robert J.} and Nemcek, {Albert A.} and Mulcahy, {Mary F.} and Kulik, {Laura M.} and Miller, {Frank H.} and Riad Salem and Omary, {Reed A.}",
year = "2008",
month = "3",
day = "1",
doi = "10.1148/radiol.2463070725",
language = "English (US)",
volume = "246",
pages = "964--971",
journal = "Radiology",
issn = "0033-8419",
publisher = "Radiological Society of North America Inc.",
number = "3",

}

TY - JOUR

T1 - Transcatheter intraarterial perfusion

T2 - MR monitoring of chemoembolization for hepatocellular carcinoma - Feasibility of initial clinical translation

AU - Larson, Andrew C.

AU - Wang, Dingxin

AU - Atassi, Bassel

AU - Sato, Kent T.

AU - Ryu, Robert K.

AU - Lewandowski, Robert J.

AU - Nemcek, Albert A.

AU - Mulcahy, Mary F.

AU - Kulik, Laura M.

AU - Miller, Frank H.

AU - Salem, Riad

AU - Omary, Reed A.

PY - 2008/3/1

Y1 - 2008/3/1

N2 - Purpose: To prospectively test the hypothesis that intraprocedural transcatheter intraarterial perfusion (TRIP) magnetic resonance (MR) imaging can be used to successfully measure reductions in perfusion to the targeted hepatocellular carcinoma (HCC) and the adjacent surrounding liver tissue during MR-interventional radiology (IR)-monitored transcatheter arterial chemoembolization (TACE). Materials and Methods: This HIPAA-compliant prospective study was approved by the institutional review board. An MR-IR unit was used to perform TACE in 10 patients with HCC (seven male, three female; eight younger than 69 years, two older than 69 years). Intraprocedural reductions in tumor perfusion before and after TACE were monitored with TRIP MR imaging. Time-signal intensity curves were derived, and semiquantitative spatially resolved area under the time-signal intensity curve maps of tumor perfusion before and after TACE were produced. Mean perfusion values before and after TACE for liver tumors and adjacent liver tissue were compared by using a mixed-model analysis, with α = .05. Results: Perfusion reductions were measured successfully with TRIP MR imaging in 18 separate tumors during 13 treatment sessions. Perfusion maps showed significant perfusion reductions for tumors (P < .013) but not for adjacent nontumorous liver tissue (P = .21). For tumors, the mean perfusion value was 193 arbitrary units (AU) ± 223 (standard deviation) before TACE and 45.3 AU ± 91.9 after TACE, with a mean reduction in baseline perfusion of 74.6% ± 24.8. For adjacent liver tissue, the mean perfusion value was 124 AU ± 93.5 before TACE and 93.2 AU ± 72.3 after TACE, with a mean reduction in baseline perfusion of 24.2% ± 14.5. Conclusion: TRIP MR imaging can be used to detect intraprocedural changes in perfusion to HCC and surrounding liver parenchyma during MR-IR-monitored TACE.

AB - Purpose: To prospectively test the hypothesis that intraprocedural transcatheter intraarterial perfusion (TRIP) magnetic resonance (MR) imaging can be used to successfully measure reductions in perfusion to the targeted hepatocellular carcinoma (HCC) and the adjacent surrounding liver tissue during MR-interventional radiology (IR)-monitored transcatheter arterial chemoembolization (TACE). Materials and Methods: This HIPAA-compliant prospective study was approved by the institutional review board. An MR-IR unit was used to perform TACE in 10 patients with HCC (seven male, three female; eight younger than 69 years, two older than 69 years). Intraprocedural reductions in tumor perfusion before and after TACE were monitored with TRIP MR imaging. Time-signal intensity curves were derived, and semiquantitative spatially resolved area under the time-signal intensity curve maps of tumor perfusion before and after TACE were produced. Mean perfusion values before and after TACE for liver tumors and adjacent liver tissue were compared by using a mixed-model analysis, with α = .05. Results: Perfusion reductions were measured successfully with TRIP MR imaging in 18 separate tumors during 13 treatment sessions. Perfusion maps showed significant perfusion reductions for tumors (P < .013) but not for adjacent nontumorous liver tissue (P = .21). For tumors, the mean perfusion value was 193 arbitrary units (AU) ± 223 (standard deviation) before TACE and 45.3 AU ± 91.9 after TACE, with a mean reduction in baseline perfusion of 74.6% ± 24.8. For adjacent liver tissue, the mean perfusion value was 124 AU ± 93.5 before TACE and 93.2 AU ± 72.3 after TACE, with a mean reduction in baseline perfusion of 24.2% ± 14.5. Conclusion: TRIP MR imaging can be used to detect intraprocedural changes in perfusion to HCC and surrounding liver parenchyma during MR-IR-monitored TACE.

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