Document Detail


MR imaging perfusion mismatch: a technique to verify successful targeting of liver tumors during transcatheter arterial chemoembolization.
MedLine Citation:
PMID:  18440458     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To evaluate the combined use of transcatheter intraarterial perfusion (TRIP) magnetic resonance (MR) imaging and dynamic contrast-enhanced MR imaging to determine complete tumor targeting during transcatheter arterial chemoembolization (TACE) when performed within an integrated MR imaging-interventional radiology (IR) angiography suite. MATERIALS AND METHODS: Between October 2006 and March 2007, eight consecutive patients with unresectable hepatocellular carcinoma (HCC) successfully underwent TACE in a combined MR imaging-IR suite. All patients were male, with a mean age of 59 years (range, 41-71 years). Tumor enhancement on TRIP MR images before and after TACE were qualitatively compared with dynamic contrast-enhanced MR images obtained after TACE. The authors computed the prevalence of perfusion mismatch. The presence of a perfusion mismatch was judged in a binary fashion. RESULTS: A perfusion match, confirming complete tumor targeting, occurred in six of the eight patients (75%). There was a perfusion mismatch in two patients (25%). Subsequent interrogation showed that the underlying cause of the mismatch was secondary to an unexpected collateral vessel in the first patient and watershed location of the tumor in the second patient. CONCLUSIONS: Performing TACE in an MR imaging-IR suite can facilitate complete tumor targeting. By comparing perfusion images from TRIP and contrast-enhanced MR sequences, the operator gains confidence and can potentially obtain more selective catheter placement during TACE.
Authors:
Robert J Lewandowski; Joshua Tepper; Dingxin Wang; Saad Ibrahim; Frank H Miller; Laura Kulik; Mary Mulcahy; Robert K Ryu; Kent Sato; Andrew C Larson; Riad Salem; Reed A Omary
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Publication Detail:
Type:  Journal Article     Date:  2008-03-17
Journal Detail:
Title:  Journal of vascular and interventional radiology : JVIR     Volume:  19     ISSN:  1051-0443     ISO Abbreviation:  J Vasc Interv Radiol     Publication Date:  2008 May 
Date Detail:
Created Date:  2008-04-28     Completed Date:  2008-09-04     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9203369     Medline TA:  J Vasc Interv Radiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  698-705     Citation Subset:  IM    
Affiliation:
Department of Radiology, Feinberg School of Medicine, Northwestern University, 676 N St Clair St, Ste 800, Chicago, IL 60611, USA. r-lewandowski@northwestern.edu
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
Carcinoma, Hepatocellular / therapy*
Chemoembolization, Therapeutic / methods*
Cisplatin / administration & dosage
Contrast Media / administration & dosage
Doxorubicin / administration & dosage
Ethiodized Oil / administration & dosage
Female
Gadolinium DTPA / administration & dosage
Humans
Infusions, Intra-Arterial
Liver Neoplasms / therapy*
Magnetic Resonance Imaging, Interventional*
Male
Middle Aged
Mitomycin / administration & dosage
Prospective Studies
Treatment Outcome
Chemical
Reg. No./Substance:
0/Contrast Media; 15663-27-1/Cisplatin; 23214-92-8/Doxorubicin; 50-07-7/Mitomycin; 8008-53-5/Ethiodized Oil; 80529-93-7/Gadolinium DTPA

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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