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首页> 外文期刊>Academic radiology >Intraprocedural transcatheter intra-arterial perfusion MRI as a predictor of tumor response to chemoembolization for hepatocellular carcinoma.
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Intraprocedural transcatheter intra-arterial perfusion MRI as a predictor of tumor response to chemoembolization for hepatocellular carcinoma.

机译：术中经导管动脉内灌注MRI可预测肝细胞癌对化学栓塞的肿瘤反应。

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RATIONALE AND OBJECTIVES: To prospectively test the hypothesis that transcatheter intraarterial perfusion magnetic resonance imaging (TRIP-MRI) measured semiquantitative perfusion reductions during transcatheter arterial chemoembolization of hepatocellular carcinoma (HCC) are associated with tumor response. MATERIALS AND METHODS: Twenty-eight patients (mean age 63 years; range 47-87 years) with 29 tumors underwent chemoembolization in a combined magnetic resonance interventional radiology suite. Intraprocedural tumor perfusion reductions during chemoembolization were monitored using TRIP-MRI. Pre- and postchemoembolization semiquantitative area under the time-signal enhancement curve (AUC) tumor perfusion was measured. Mean tumor perfusion pre- and postchemoembolization were compared using a paired t-test. Imaging follow-up was performed 1-3 months after chemoembolization. We studied the relationship between short-term tumor imaging response and intraprocedural perfusion reductions using univariate and multivariate analysis. RESULTS: Intraprocedural AUC perfusion value decreased significantly after chemoembolization (342.1 vs. 158.6 arbitrary unit, P < .001). Twenty-six patients with 27 HCCs (n = 27) had follow-up imaging at mean 39 days postchemoembolization. Favorable response was present in 67% of these treated tumors according to necrosis criteria. Fifteen of 16 (94%) tumors with 25%-75% perfusion reductions showed necrosis treatment response compared to only 3 of 11 (27%) tumors with perfusion reductions outside the above range (P = .001). Multivariate logistic regression indicated that intraprocedural tumor perfusion reduction and Child-Pugh class were independent factors associated significantly with tumor response (P = .012 and .047, respectively). CONCLUSION: TRIP-MRI can successfully measure semiquantitative changes in HCC perfusion during chemoembolization. Intraprocedural tumor perfusion reductions are associated with future tumor response.
机译：理由和目的：为了前瞻性地检验经导管动脉内灌注磁共振成像（TRIP-MRI）测量的肝癌经导管动脉化学栓塞期间半定量灌注减少与肿瘤反应相关的假设。材料与方法：28例29例肿瘤患者（平均年龄63岁;范围47-87岁）在联合磁共振介入放射学套件中进行了化学栓塞术。使用TRIP-MRI监测化学栓塞过程中的术中肿瘤灌注减少。测量时间-信号增强曲线（AUC）肿瘤灌注下的化学栓塞前后的半定量面积。使用配对t检验比较平均化疗前和化疗后肿瘤灌注。化学栓塞后1-3个月进行影像学随访。我们使用单因素和多因素分析研究了短期肿瘤影像学反应与术中灌注减少之间的关系。结果：化学栓塞后术中AUC灌注值显着降低（342.1 vs. 158.6任意单位，P <.001）。 26例27例HCC患者（n = 27）在平均栓塞后39天进行了随访。根据坏死标准，在这些治疗的肿瘤中67％存在良好的反应。 16例（94％）灌注减少25％-75％的肿瘤中有15例显示坏死治疗反应，而11例（27％）灌注减少超出上述范围的肿瘤中只有3例（P = .001）。多因素逻辑回归分析表明，术中肿瘤灌注减少和Child-Pugh类是与肿瘤反应显着相关的独立因素（分别为P = 0.012和0.047）。结论：TRIP-MRI可以成功地测量化学栓塞过程中HCC灌注的半定量变化。术中肿瘤灌注减少与将来的肿瘤反应有关。

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