Functional MRI evaluation of tumor response in patients with neuroendocrine hepatic metastasis treated with transcatheter arterial chemoembolization

Eleni A Liapi, Jean Francois Geschwind, Josephina A. Vossen, Manon Buijs, Christos S Georgiades, David A. Bluemke, Ihab R Kamel

Research output: Contribution to journalArticle

Abstract

OBJECTIVE. The purpose of this study was to evaluate contrast-enhanced and diffusion-weighted MRI changes in neuroendocrine tumors treated with transcatheter arterial chemoembolization (TACE). MATERIALS AND METHODS. Sixty-six targeted lesions in 26 patients (18 men, eight women; mean age, 57 years) with hepatic metastasis of neuroendocrine tumors treated with TACE were retrospectively analyzed. MRI studies were performed before and after TACE. Imaging features included tumor size, percentage of enhancement in the arterial and portal venous phases, and diffusion-weighted imaging apparent diffusion coefficients (ADCs) of the tumor, liver, and spleen. Tumor response to treatment was recorded according to World Health Organization criteria and Response Evaluation Criteria in Solid Tumors. Liver function tests were performed, and clinical performance was assessed before and after treatment. Statistical analysis included paired Student's t tests and Kaplan-Meier survival curves. RESULTS. Mean tumor size and percentage enhancement in the arterial and portal venous phases decreased significantly after treatment (p <0.0001). The tumor ADC increased from 1.51 × 10-3 mm2/s before treatment to 1.79 × 10-3 mm2/s after treatment (p <0.0001), but the ADCs for the liver and spleen remained unchanged. Despite the change in tumor size, no patient in this cohort achieved complete response according to World Health Organization criteria and Response Evaluation Criteria in Solid Tumors. Partial response was achieved in only 27% and 23% of the patients according to the respective criteria. Results of liver function tests and performance status also remained unchanged. The mean survival period for all patients was 78 months. CONCLUSION. Contrast-enhanced and diffusion-weighted imaging showed significant changes after TACE of neuroendocrine tumors and can be used to assess response of targeted tumors.

Original languageEnglish (US)
Pages (from-to)67-73
Number of pages7
JournalAmerican Journal of Roentgenology
Volume190
Issue number1
DOIs
StatePublished - Jan 2008

Fingerprint

Magnetic Resonance Imaging
Neoplasm Metastasis
Liver
Neuroendocrine Tumors
Neoplasms
Liver Function Tests
Spleen
Therapeutics
Diffusion Magnetic Resonance Imaging
Kaplan-Meier Estimate
Students
Survival
Response Evaluation Criteria in Solid Tumors

Keywords

  • Diffusion-weighted MRI
  • Dynamic contrast-enhanced MRI
  • Liver
  • Transcatheter arterial chemoembolization

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Radiological and Ultrasound Technology

Cite this

Functional MRI evaluation of tumor response in patients with neuroendocrine hepatic metastasis treated with transcatheter arterial chemoembolization. / Liapi, Eleni A; Geschwind, Jean Francois; Vossen, Josephina A.; Buijs, Manon; Georgiades, Christos S; Bluemke, David A.; Kamel, Ihab R.

In: American Journal of Roentgenology, Vol. 190, No. 1, 01.2008, p. 67-73.

Research output: Contribution to journalArticle

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abstract = "OBJECTIVE. The purpose of this study was to evaluate contrast-enhanced and diffusion-weighted MRI changes in neuroendocrine tumors treated with transcatheter arterial chemoembolization (TACE). MATERIALS AND METHODS. Sixty-six targeted lesions in 26 patients (18 men, eight women; mean age, 57 years) with hepatic metastasis of neuroendocrine tumors treated with TACE were retrospectively analyzed. MRI studies were performed before and after TACE. Imaging features included tumor size, percentage of enhancement in the arterial and portal venous phases, and diffusion-weighted imaging apparent diffusion coefficients (ADCs) of the tumor, liver, and spleen. Tumor response to treatment was recorded according to World Health Organization criteria and Response Evaluation Criteria in Solid Tumors. Liver function tests were performed, and clinical performance was assessed before and after treatment. Statistical analysis included paired Student's t tests and Kaplan-Meier survival curves. RESULTS. Mean tumor size and percentage enhancement in the arterial and portal venous phases decreased significantly after treatment (p <0.0001). The tumor ADC increased from 1.51 × 10-3 mm2/s before treatment to 1.79 × 10-3 mm2/s after treatment (p <0.0001), but the ADCs for the liver and spleen remained unchanged. Despite the change in tumor size, no patient in this cohort achieved complete response according to World Health Organization criteria and Response Evaluation Criteria in Solid Tumors. Partial response was achieved in only 27{\%} and 23{\%} of the patients according to the respective criteria. Results of liver function tests and performance status also remained unchanged. The mean survival period for all patients was 78 months. CONCLUSION. Contrast-enhanced and diffusion-weighted imaging showed significant changes after TACE of neuroendocrine tumors and can be used to assess response of targeted tumors.",
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AU - Geschwind, Jean Francois

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AU - Buijs, Manon

AU - Georgiades, Christos S

AU - Bluemke, David A.

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N2 - OBJECTIVE. The purpose of this study was to evaluate contrast-enhanced and diffusion-weighted MRI changes in neuroendocrine tumors treated with transcatheter arterial chemoembolization (TACE). MATERIALS AND METHODS. Sixty-six targeted lesions in 26 patients (18 men, eight women; mean age, 57 years) with hepatic metastasis of neuroendocrine tumors treated with TACE were retrospectively analyzed. MRI studies were performed before and after TACE. Imaging features included tumor size, percentage of enhancement in the arterial and portal venous phases, and diffusion-weighted imaging apparent diffusion coefficients (ADCs) of the tumor, liver, and spleen. Tumor response to treatment was recorded according to World Health Organization criteria and Response Evaluation Criteria in Solid Tumors. Liver function tests were performed, and clinical performance was assessed before and after treatment. Statistical analysis included paired Student's t tests and Kaplan-Meier survival curves. RESULTS. Mean tumor size and percentage enhancement in the arterial and portal venous phases decreased significantly after treatment (p <0.0001). The tumor ADC increased from 1.51 × 10-3 mm2/s before treatment to 1.79 × 10-3 mm2/s after treatment (p <0.0001), but the ADCs for the liver and spleen remained unchanged. Despite the change in tumor size, no patient in this cohort achieved complete response according to World Health Organization criteria and Response Evaluation Criteria in Solid Tumors. Partial response was achieved in only 27% and 23% of the patients according to the respective criteria. Results of liver function tests and performance status also remained unchanged. The mean survival period for all patients was 78 months. CONCLUSION. Contrast-enhanced and diffusion-weighted imaging showed significant changes after TACE of neuroendocrine tumors and can be used to assess response of targeted tumors.

AB - OBJECTIVE. The purpose of this study was to evaluate contrast-enhanced and diffusion-weighted MRI changes in neuroendocrine tumors treated with transcatheter arterial chemoembolization (TACE). MATERIALS AND METHODS. Sixty-six targeted lesions in 26 patients (18 men, eight women; mean age, 57 years) with hepatic metastasis of neuroendocrine tumors treated with TACE were retrospectively analyzed. MRI studies were performed before and after TACE. Imaging features included tumor size, percentage of enhancement in the arterial and portal venous phases, and diffusion-weighted imaging apparent diffusion coefficients (ADCs) of the tumor, liver, and spleen. Tumor response to treatment was recorded according to World Health Organization criteria and Response Evaluation Criteria in Solid Tumors. Liver function tests were performed, and clinical performance was assessed before and after treatment. Statistical analysis included paired Student's t tests and Kaplan-Meier survival curves. RESULTS. Mean tumor size and percentage enhancement in the arterial and portal venous phases decreased significantly after treatment (p <0.0001). The tumor ADC increased from 1.51 × 10-3 mm2/s before treatment to 1.79 × 10-3 mm2/s after treatment (p <0.0001), but the ADCs for the liver and spleen remained unchanged. Despite the change in tumor size, no patient in this cohort achieved complete response according to World Health Organization criteria and Response Evaluation Criteria in Solid Tumors. Partial response was achieved in only 27% and 23% of the patients according to the respective criteria. Results of liver function tests and performance status also remained unchanged. The mean survival period for all patients was 78 months. CONCLUSION. Contrast-enhanced and diffusion-weighted imaging showed significant changes after TACE of neuroendocrine tumors and can be used to assess response of targeted tumors.

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KW - Dynamic contrast-enhanced MRI

KW - Liver

KW - Transcatheter arterial chemoembolization

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