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fMRI Predicts Again April 1, 2008

Posted by tomography in fMRI, Radiology.
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Almost all cancers metastasize to the liver leading to slow but certain organ failure and death. Such metastases do not leave too many options for the clinician. Most of the time treatment is only palliative, but in certain cases treatment may be achieved and the patient’s life prolonged.

One such treatment option is transarterial chemoembolization (TACE). Researchers from Johns Hopkins University and Northwestern University say that the effects of TACE on liver metasteses from neuroendocrine tumors may be predicted by fMRI.

“Naik and colleagues enrolled 21 patients with HCC who underwent TACE and intra/postprocedural 1.5T gadolinium-enhanced T1-weighted MR and DWI with follow-up at one and three months. The investigators found DWI changes did occur a few weeks after treatment began and they were useful to predict TACE effects two months before they actually took place and became evident on imaging.

In another study, interventional radiology fellow Dr. Josephina A. Vossen and colleagues at Johns Hopkins evaluated 19 patients with unresectable primary (n = 11) and metastatic (n = 8) liver tumors treated with TACE. Patients underwent unenhanced/contrast-enhanced MRI and MR spectroscopy before and after a single treatment. Two radiologists interpreted results by consensus.

They found 11 patients with successful tumor embolization showed loss of choline peak on MR spectroscopy, significant increase in apparent diffusion coefficient values (22%, p = 0.004), and significant decrease in tumor arterial and venous enhancement (43%, p = 0.005 and 40%, p = 0.002, respectively). Patients with no evidence of tumor response had a stable choline concentration, tumor enhancement, and ADC.”

These functional findings preceded tumor regression in size, and may be utilized to detect early therapeutic response

Vossen said.

Conclusion: Contrast enhancement and metabolic changes detected with functional MR imaging can be used to anticipate the effects of transarterial chemoembolization on primary and metastatic tumors of the liver.

Read the article here.

– Andras

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