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VX2 Carcinoma in Rabbits after Radiofrequency Ablation: Comparison of MR Contrast Agents for Help in Differentiating Benign Periablational Enhancement from Residual Tumor¹

¹ From the Department of Radiology and Clinical Research Institute, Seoul National University Hospital (T.J.K., W.K.M., J.H.C., J.M.G., K.H.L., K.H.K., J.W.L., J.G.H., K.H.C.) and the Institute of Radiation Medicine, Seoul National University Medical Research Center (T.J.K., W.K.M.), 28 Yongon-dong, Chongno-gu, Seoul 110–744, Korea; and Department of Contrast Media Research, Schering, Berlin, Germany (H.J.W.). Supported by grant of the National R & D Program for Cancer Control, Ministry of Health & Welfare, Republic of Korea (0420080–1). W.K.M. supported by a grant from Schering, Berlin, Germany. Received September 11, 2003; revision requested November 24; revision received March 12, 2004; accepted April 22. Address correspondence to W.K.M. (e-mail: moonwk@radcom.snu.ac.kr).

View larger version (128K): [in a new window]   Figure 1a. Transverse spin-echo MR images (a-f) and a photomicrograph (g) of a back muscle 1 week after RF ablation of VX2 tumor with the rabbit in prone position. (a) T2-weighted image (4000/96) obtained before injection of SH L 643A shows heterogeneous-signal-intensity mass with hyperintense center and surrounding hyperintense rim (arrowheads). A hyperintense nodule (arrow) abutting the treated area is suspicious for residual tumor. (b) T1-weighted image (450/16) obtained before injection of SH L 643A shows slightly hyperintense mass with irregular margin compared to signal intensity of psoas muscle. (c) T1-weighted image (450/16) obtained 2 minutes after injection of SH L 643A shows nodular enhancing residual tumor (arrow) with rim enhancement (arrowheads) along the ablated margin. Note mild enhancement of the surrounding rim compared to that of nodular lesion. (d) T1-weighted image (450/16) obtained 10 minutes after injection of SH L 643A shows that enhancement of residual tumor is greater than that seen in c. The peripheral nodular enhancing tumor (arrow) and rim enhancement (arrowheads) demonstrate more discrete margins compared to those seen in e. (e) T1-weighted image (450/16) obtained 2 minutes after injection of gadopentetate dimeglumine also shows nodular enhancing residual tumor (arrow) with rim enhancement (arrowheads) along the ablated margin. Note strong enhancement of the surrounding rim compared to that of residual tumor. (f) T1-weighted image (450/16) obtained 10 minutes after injection of gadopentetate dimeglumine also shows both nodular enhancing residual tumor (arrow) and rim enhancement (arrowheads) but allows only poor differentiation between these two areas compared to e. (g) Photomicrograph shows viable tumor (arrows) and mixture of inflammatory granulation tissue and early fibrosis (arrowheads), which correspond to enhancing nodule and the peripheral rim at contrast-enhanced MR imaging, respectively. Necrotic areas filled with degenerated tumor cells and tissue loss surrounding the inserted needle correspond to the two inner zones on T2-weighted MR images and unenhanced ablated tumor on contrast-enhanced MR images. (Hematoxylin-eosin stain; original magnification, x2.)

View larger version (110K): [in a new window]   Figure 1b. Transverse spin-echo MR images (a-f) and a photomicrograph (g) of a back muscle 1 week after RF ablation of VX2 tumor with the rabbit in prone position. (a) T2-weighted image (4000/96) obtained before injection of SH L 643A shows heterogeneous-signal-intensity mass with hyperintense center and surrounding hyperintense rim (arrowheads). A hyperintense nodule (arrow) abutting the treated area is suspicious for residual tumor. (b) T1-weighted image (450/16) obtained before injection of SH L 643A shows slightly hyperintense mass with irregular margin compared to signal intensity of psoas muscle. (c) T1-weighted image (450/16) obtained 2 minutes after injection of SH L 643A shows nodular enhancing residual tumor (arrow) with rim enhancement (arrowheads) along the ablated margin. Note mild enhancement of the surrounding rim compared to that of nodular lesion. (d) T1-weighted image (450/16) obtained 10 minutes after injection of SH L 643A shows that enhancement of residual tumor is greater than that seen in c. The peripheral nodular enhancing tumor (arrow) and rim enhancement (arrowheads) demonstrate more discrete margins compared to those seen in e. (e) T1-weighted image (450/16) obtained 2 minutes after injection of gadopentetate dimeglumine also shows nodular enhancing residual tumor (arrow) with rim enhancement (arrowheads) along the ablated margin. Note strong enhancement of the surrounding rim compared to that of residual tumor. (f) T1-weighted image (450/16) obtained 10 minutes after injection of gadopentetate dimeglumine also shows both nodular enhancing residual tumor (arrow) and rim enhancement (arrowheads) but allows only poor differentiation between these two areas compared to e. (g) Photomicrograph shows viable tumor (arrows) and mixture of inflammatory granulation tissue and early fibrosis (arrowheads), which correspond to enhancing nodule and the peripheral rim at contrast-enhanced MR imaging, respectively. Necrotic areas filled with degenerated tumor cells and tissue loss surrounding the inserted needle correspond to the two inner zones on T2-weighted MR images and unenhanced ablated tumor on contrast-enhanced MR images. (Hematoxylin-eosin stain; original magnification, x2.)

View larger version (117K): [in a new window]   Figure 1c. Transverse spin-echo MR images (a-f) and a photomicrograph (g) of a back muscle 1 week after RF ablation of VX2 tumor with the rabbit in prone position. (a) T2-weighted image (4000/96) obtained before injection of SH L 643A shows heterogeneous-signal-intensity mass with hyperintense center and surrounding hyperintense rim (arrowheads). A hyperintense nodule (arrow) abutting the treated area is suspicious for residual tumor. (b) T1-weighted image (450/16) obtained before injection of SH L 643A shows slightly hyperintense mass with irregular margin compared to signal intensity of psoas muscle. (c) T1-weighted image (450/16) obtained 2 minutes after injection of SH L 643A shows nodular enhancing residual tumor (arrow) with rim enhancement (arrowheads) along the ablated margin. Note mild enhancement of the surrounding rim compared to that of nodular lesion. (d) T1-weighted image (450/16) obtained 10 minutes after injection of SH L 643A shows that enhancement of residual tumor is greater than that seen in c. The peripheral nodular enhancing tumor (arrow) and rim enhancement (arrowheads) demonstrate more discrete margins compared to those seen in e. (e) T1-weighted image (450/16) obtained 2 minutes after injection of gadopentetate dimeglumine also shows nodular enhancing residual tumor (arrow) with rim enhancement (arrowheads) along the ablated margin. Note strong enhancement of the surrounding rim compared to that of residual tumor. (f) T1-weighted image (450/16) obtained 10 minutes after injection of gadopentetate dimeglumine also shows both nodular enhancing residual tumor (arrow) and rim enhancement (arrowheads) but allows only poor differentiation between these two areas compared to e. (g) Photomicrograph shows viable tumor (arrows) and mixture of inflammatory granulation tissue and early fibrosis (arrowheads), which correspond to enhancing nodule and the peripheral rim at contrast-enhanced MR imaging, respectively. Necrotic areas filled with degenerated tumor cells and tissue loss surrounding the inserted needle correspond to the two inner zones on T2-weighted MR images and unenhanced ablated tumor on contrast-enhanced MR images. (Hematoxylin-eosin stain; original magnification, x2.)

View larger version (120K): [in a new window]   Figure 1d. Transverse spin-echo MR images (a-f) and a photomicrograph (g) of a back muscle 1 week after RF ablation of VX2 tumor with the rabbit in prone position. (a) T2-weighted image (4000/96) obtained before injection of SH L 643A shows heterogeneous-signal-intensity mass with hyperintense center and surrounding hyperintense rim (arrowheads). A hyperintense nodule (arrow) abutting the treated area is suspicious for residual tumor. (b) T1-weighted image (450/16) obtained before injection of SH L 643A shows slightly hyperintense mass with irregular margin compared to signal intensity of psoas muscle. (c) T1-weighted image (450/16) obtained 2 minutes after injection of SH L 643A shows nodular enhancing residual tumor (arrow) with rim enhancement (arrowheads) along the ablated margin. Note mild enhancement of the surrounding rim compared to that of nodular lesion. (d) T1-weighted image (450/16) obtained 10 minutes after injection of SH L 643A shows that enhancement of residual tumor is greater than that seen in c. The peripheral nodular enhancing tumor (arrow) and rim enhancement (arrowheads) demonstrate more discrete margins compared to those seen in e. (e) T1-weighted image (450/16) obtained 2 minutes after injection of gadopentetate dimeglumine also shows nodular enhancing residual tumor (arrow) with rim enhancement (arrowheads) along the ablated margin. Note strong enhancement of the surrounding rim compared to that of residual tumor. (f) T1-weighted image (450/16) obtained 10 minutes after injection of gadopentetate dimeglumine also shows both nodular enhancing residual tumor (arrow) and rim enhancement (arrowheads) but allows only poor differentiation between these two areas compared to e. (g) Photomicrograph shows viable tumor (arrows) and mixture of inflammatory granulation tissue and early fibrosis (arrowheads), which correspond to enhancing nodule and the peripheral rim at contrast-enhanced MR imaging, respectively. Necrotic areas filled with degenerated tumor cells and tissue loss surrounding the inserted needle correspond to the two inner zones on T2-weighted MR images and unenhanced ablated tumor on contrast-enhanced MR images. (Hematoxylin-eosin stain; original magnification, x2.)

View larger version (131K): [in a new window]   Figure 1e. Transverse spin-echo MR images (a-f) and a photomicrograph (g) of a back muscle 1 week after RF ablation of VX2 tumor with the rabbit in prone position. (a) T2-weighted image (4000/96) obtained before injection of SH L 643A shows heterogeneous-signal-intensity mass with hyperintense center and surrounding hyperintense rim (arrowheads). A hyperintense nodule (arrow) abutting the treated area is suspicious for residual tumor. (b) T1-weighted image (450/16) obtained before injection of SH L 643A shows slightly hyperintense mass with irregular margin compared to signal intensity of psoas muscle. (c) T1-weighted image (450/16) obtained 2 minutes after injection of SH L 643A shows nodular enhancing residual tumor (arrow) with rim enhancement (arrowheads) along the ablated margin. Note mild enhancement of the surrounding rim compared to that of nodular lesion. (d) T1-weighted image (450/16) obtained 10 minutes after injection of SH L 643A shows that enhancement of residual tumor is greater than that seen in c. The peripheral nodular enhancing tumor (arrow) and rim enhancement (arrowheads) demonstrate more discrete margins compared to those seen in e. (e) T1-weighted image (450/16) obtained 2 minutes after injection of gadopentetate dimeglumine also shows nodular enhancing residual tumor (arrow) with rim enhancement (arrowheads) along the ablated margin. Note strong enhancement of the surrounding rim compared to that of residual tumor. (f) T1-weighted image (450/16) obtained 10 minutes after injection of gadopentetate dimeglumine also shows both nodular enhancing residual tumor (arrow) and rim enhancement (arrowheads) but allows only poor differentiation between these two areas compared to e. (g) Photomicrograph shows viable tumor (arrows) and mixture of inflammatory granulation tissue and early fibrosis (arrowheads), which correspond to enhancing nodule and the peripheral rim at contrast-enhanced MR imaging, respectively. Necrotic areas filled with degenerated tumor cells and tissue loss surrounding the inserted needle correspond to the two inner zones on T2-weighted MR images and unenhanced ablated tumor on contrast-enhanced MR images. (Hematoxylin-eosin stain; original magnification, x2.)

View larger version (132K): [in a new window]   Figure 1f. Transverse spin-echo MR images (a-f) and a photomicrograph (g) of a back muscle 1 week after RF ablation of VX2 tumor with the rabbit in prone position. (a) T2-weighted image (4000/96) obtained before injection of SH L 643A shows heterogeneous-signal-intensity mass with hyperintense center and surrounding hyperintense rim (arrowheads). A hyperintense nodule (arrow) abutting the treated area is suspicious for residual tumor. (b) T1-weighted image (450/16) obtained before injection of SH L 643A shows slightly hyperintense mass with irregular margin compared to signal intensity of psoas muscle. (c) T1-weighted image (450/16) obtained 2 minutes after injection of SH L 643A shows nodular enhancing residual tumor (arrow) with rim enhancement (arrowheads) along the ablated margin. Note mild enhancement of the surrounding rim compared to that of nodular lesion. (d) T1-weighted image (450/16) obtained 10 minutes after injection of SH L 643A shows that enhancement of residual tumor is greater than that seen in c. The peripheral nodular enhancing tumor (arrow) and rim enhancement (arrowheads) demonstrate more discrete margins compared to those seen in e. (e) T1-weighted image (450/16) obtained 2 minutes after injection of gadopentetate dimeglumine also shows nodular enhancing residual tumor (arrow) with rim enhancement (arrowheads) along the ablated margin. Note strong enhancement of the surrounding rim compared to that of residual tumor. (f) T1-weighted image (450/16) obtained 10 minutes after injection of gadopentetate dimeglumine also shows both nodular enhancing residual tumor (arrow) and rim enhancement (arrowheads) but allows only poor differentiation between these two areas compared to e. (g) Photomicrograph shows viable tumor (arrows) and mixture of inflammatory granulation tissue and early fibrosis (arrowheads), which correspond to enhancing nodule and the peripheral rim at contrast-enhanced MR imaging, respectively. Necrotic areas filled with degenerated tumor cells and tissue loss surrounding the inserted needle correspond to the two inner zones on T2-weighted MR images and unenhanced ablated tumor on contrast-enhanced MR images. (Hematoxylin-eosin stain; original magnification, x2.)

View larger version (152K): [in a new window]   Figure 1g. Transverse spin-echo MR images (a-f) and a photomicrograph (g) of a back muscle 1 week after RF ablation of VX2 tumor with the rabbit in prone position. (a) T2-weighted image (4000/96) obtained before injection of SH L 643A shows heterogeneous-signal-intensity mass with hyperintense center and surrounding hyperintense rim (arrowheads). A hyperintense nodule (arrow) abutting the treated area is suspicious for residual tumor. (b) T1-weighted image (450/16) obtained before injection of SH L 643A shows slightly hyperintense mass with irregular margin compared to signal intensity of psoas muscle. (c) T1-weighted image (450/16) obtained 2 minutes after injection of SH L 643A shows nodular enhancing residual tumor (arrow) with rim enhancement (arrowheads) along the ablated margin. Note mild enhancement of the surrounding rim compared to that of nodular lesion. (d) T1-weighted image (450/16) obtained 10 minutes after injection of SH L 643A shows that enhancement of residual tumor is greater than that seen in c. The peripheral nodular enhancing tumor (arrow) and rim enhancement (arrowheads) demonstrate more discrete margins compared to those seen in e. (e) T1-weighted image (450/16) obtained 2 minutes after injection of gadopentetate dimeglumine also shows nodular enhancing residual tumor (arrow) with rim enhancement (arrowheads) along the ablated margin. Note strong enhancement of the surrounding rim compared to that of residual tumor. (f) T1-weighted image (450/16) obtained 10 minutes after injection of gadopentetate dimeglumine also shows both nodular enhancing residual tumor (arrow) and rim enhancement (arrowheads) but allows only poor differentiation between these two areas compared to e. (g) Photomicrograph shows viable tumor (arrows) and mixture of inflammatory granulation tissue and early fibrosis (arrowheads), which correspond to enhancing nodule and the peripheral rim at contrast-enhanced MR imaging, respectively. Necrotic areas filled with degenerated tumor cells and tissue loss surrounding the inserted needle correspond to the two inner zones on T2-weighted MR images and unenhanced ablated tumor on contrast-enhanced MR images. (Hematoxylin-eosin stain; original magnification, x2.)

View larger version (28K): [in a new window]   Figure 2a. Graphs show mean enhancement ratio of residual tumor and benign periablational enhancement after injection of 0.05 mmol/kg SH L 643A in (a) early, (b) 1-week, and (c) 4-week groups. Delayed peak enhancement and slow decay are seen in both residual tumor and benign periablational enhancement after injection. Enhancement ratios of residual tumor are significantly higher than those of benign periablational enhancement up to 30 minutes in all three groups (P < .01). Error bars represent standard deviations.

View larger version (32K): [in a new window]   Figure 2b. Graphs show mean enhancement ratio of residual tumor and benign periablational enhancement after injection of 0.05 mmol/kg SH L 643A in (a) early, (b) 1-week, and (c) 4-week groups. Delayed peak enhancement and slow decay are seen in both residual tumor and benign periablational enhancement after injection. Enhancement ratios of residual tumor are significantly higher than those of benign periablational enhancement up to 30 minutes in all three groups (P < .01). Error bars represent standard deviations.

View larger version (31K): [in a new window]   Figure 2c. Graphs show mean enhancement ratio of residual tumor and benign periablational enhancement after injection of 0.05 mmol/kg SH L 643A in (a) early, (b) 1-week, and (c) 4-week groups. Delayed peak enhancement and slow decay are seen in both residual tumor and benign periablational enhancement after injection. Enhancement ratios of residual tumor are significantly higher than those of benign periablational enhancement up to 30 minutes in all three groups (P < .01). Error bars represent standard deviations.

View larger version (31K): [in a new window]   Figure 3a. Graphs show mean enhancement ratio of residual tumor and benign periablational enhancement after injection of 0.1 mmol/kg gadopentetate dimeglumine in (a) early, (b) 1-week, and (c) 4-week groups. Early peak enhancement and rapid decay in both residual tumor and benign periablational enhancement are seen after injection. Enhancement ratios of residual tumor are not significantly higher than those of benign periablational enhancement up to 30 minutes in all three groups (P > .05), except for 1 and 2 minutes in the 4-week group (P < .05). Error bars represent standard deviations.

View larger version (31K): [in a new window]   Figure 3b. Graphs show mean enhancement ratio of residual tumor and benign periablational enhancement after injection of 0.1 mmol/kg gadopentetate dimeglumine in (a) early, (b) 1-week, and (c) 4-week groups. Early peak enhancement and rapid decay in both residual tumor and benign periablational enhancement are seen after injection. Enhancement ratios of residual tumor are not significantly higher than those of benign periablational enhancement up to 30 minutes in all three groups (P > .05), except for 1 and 2 minutes in the 4-week group (P < .05). Error bars represent standard deviations.

View larger version (29K): [in a new window]   Figure 3c. Graphs show mean enhancement ratio of residual tumor and benign periablational enhancement after injection of 0.1 mmol/kg gadopentetate dimeglumine in (a) early, (b) 1-week, and (c) 4-week groups. Early peak enhancement and rapid decay in both residual tumor and benign periablational enhancement are seen after injection. Enhancement ratios of residual tumor are not significantly higher than those of benign periablational enhancement up to 30 minutes in all three groups (P > .05), except for 1 and 2 minutes in the 4-week group (P < .05). Error bars represent standard deviations.