HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Figures Only Full Text Full Text (PDF) Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Larson, A. C. Articles by Omary, R. A. Search for Related Content PubMed PubMed Citation Articles by Larson, A. C. Articles by Omary, R. A.

Transcatheter Intraarterial Perfusion: MR Monitoring of Chemoembolization for Hepatocellular Carcinoma—Feasibility of Initial Clinical Translation¹

¹ From the Departments of Radiology (A.C.L., D.W., B.A., K.T.S., R.K.R., R.J.L., A.A.N., F.H.M., R.S., R.A.O.), Biomedical Engineering (A.C.L., D.W., R.A.O.), Medicine (M.F.M., R.S.), and Hepatology (L.M.K.), Feinberg School of Medicine; and the Robert H. Lurie Comprehensive Cancer Center (A.C.L., M.F.M., R.S., R.A.O.), Northwestern University, 448 E Ontario St, Suite 700, Chicago, IL 60611. Received April 23, 2007; revision requested June 18; revision received July 23; accepted August 20; final version accepted September 26. Address correspondence to R.A.O. (e-mail: reed{at}northwestern.edu).

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 = .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.

© RSNA, 2008