Functional MR imaging as a new paradigm for image guidance

Area of Science:

• Radiology and Medical Imaging
• Oncology
• Interventional Radiology

Background:

• Locoregional minimally invasive treatments for liver tumors require precise guidance and monitoring for therapeutic success.
• Current assessment criteria like RECIST and EASL, based on tumor size and enhancement, have limitations in evaluating treatment response.
• There is a need for advanced imaging techniques that provide in vivo physiologic and metabolic information for better tumor assessment.

Purpose of the Study:

• To review advanced Magnetic Resonance (MR) imaging techniques for guiding and monitoring minimally invasive liver tumor treatments.
• To explore how MR spectroscopy, diffusion, and perfusion imaging can offer additional criteria for assessing tumor response.
• To discuss the role of these advanced MR techniques alongside traditional metrics and interventional procedures.

Main Methods:

• Review of advanced MR imaging techniques: MR spectroscopy, diffusion-weighted imaging (DWI), and perfusion MR imaging.
• Analysis of how these techniques provide in vivo physiologic and metabolic data.
• Discussion of findings in conjunction with established criteria (RECIST, EASL) and interventional procedures (RFA, TACE, radioembolization).

Main Results:

• Advanced MR imaging techniques provide crucial in vivo physiologic and metabolic information for liver tumor assessment.
• Apparent diffusion coefficient (ADC) findings, alongside tumor size and enhancement, offer supplementary data post-treatment.
• These advanced techniques have the potential to enhance the evaluation of treatment response beyond current limitations.

Conclusions:

• Advanced MR imaging techniques, including MR spectroscopy, diffusion, and perfusion, are valuable tools for monitoring liver tumor treatments.
• These methods can supplement existing criteria by providing deeper insights into tumor physiology and metabolism.
• Integrating advanced MR findings with traditional assessments can lead to more accurate and effective evaluation of minimally invasive therapies.