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Hepatocellular carcinoma: perfusion quantification with dynamic contrast-enhanced MRI
Bachir Taouli1, R Scott Johnson, Cristina H Hajdu
11 Department of Radiology, Body MRI, Translational and Molecular Imaging Institute, Mount Sinai School of Medicine, One Gustave Levy Pl, Box 1234, New York, NY 10029.
AJR. American Journal of Roentgenology
|September 25, 2013
Summary
Dynamic contrast-enhanced MRI (DCE-MRI) quantifies liver perfusion in hepatocellular carcinoma (HCC). DCE-MRI assesses perfusion changes after HCC chemoembolization, offering insights into treatment effectiveness.
Area of Science:
- Radiology
- Hepatobiliary Imaging
- Oncology
Background:
- Hepatocellular carcinoma (HCC) is a primary liver malignancy.
- Accurate assessment of tumor vascularity is crucial for diagnosis and treatment monitoring.
- Dynamic contrast-enhanced MRI (DCE-MRI) offers advanced imaging capabilities for liver lesions.
Purpose of the Study:
- To evaluate the initial experience with DCE-MRI for quantifying liver perfusion in HCC.
- To compare perfusion parameters between HCC lesions and surrounding liver parenchyma.
- To assess the impact of chemoembolization on HCC perfusion using DCE-MRI.
Main Methods:
- Prospective DCE-MRI of the liver was performed on 31 patients with HCC using a 3D FLASH sequence at 1.5 T.
- Regions of interest were analyzed in the aorta, portal vein, liver parenchyma, and HCC lesions.
- Perfusion parameters including arterial flow, portal venous flow, arterial fraction, distribution volume, and mean transit time (MTT) were calculated using a dual-input single-compartment model.
Main Results:
- Thirty-three HCCs were evaluated. HCC demonstrated significantly higher arterial hepatic blood flow and arterial fraction compared to liver parenchyma (p < 0.0001).
- HCC showed significantly lower distribution volume and portal venous hepatic blood flow than liver parenchyma (p < 0.0001-0.023).
- Untreated HCCs exhibited a higher arterial fraction and lower portal venous hepatic blood flow than chemoembolized HCCs (p < 0.04).
Conclusions:
- DCE-MRI is effective for quantifying perfusion metrics in HCC and surrounding liver parenchyma.
- DCE-MRI can successfully assess perfusion changes in HCC following chemoembolization.
- This technique provides valuable insights into the hemodynamic characteristics of HCC and its response to treatment.
