• J Comput Assist Tomogr · May 2008

    Comparative Study

    Role of functional magnetic resonance imaging in assessing metastatic leiomyosarcoma response to chemoembolization.

    • Josephina A Vossen, Ihab R Kamel, Manon Buijs, Eleni Liapi, Christos S Georgiades, Kelvin Hong, and Jean-Francois H Geschwind.
    • Russel H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins Hospital, 601 N. Caroline Street, Baltimore, MD 21287, USA.
    • J Comput Assist Tomogr. 2008 May 1; 32 (3): 347-52.

    PurposeTo assess the value of functional magnetic resonance (MR) imaging in the evaluation of early tumor response after transarterial chemoembolization (TACE) for metastatic leiomyosarcoma and compare tumor response using functional MR imaging versus traditional imaging response assessment, which is based on tumor size.Materials And MethodsWe evaluated 31 lesions in 10 patients with liver metastases from leiomyosarcoma using MR imaging studies before and after TACE. Diffusion and contrast-enhanced MR imaging was performed on a 1.5-T unit. Imaging protocol consisted of T2-weighted fast spin-echo images, breath-hold diffusion-weighted echo-planar images, and breath-hold unenhanced and contrast-enhanced T1-weighted 3-dimensional fat-suppressed spoiled gradient-echo images in the arterial phase (20 seconds) and portal venous phase (60 seconds). Parameters evaluated included change in tumor size, enhancement, and apparent diffusion coefficient (ADC) values. Median survival was also calculated for the entire cohort.ResultsThe 31 lesions evaluated had a mean size of 4.8 cm before treatment. Tumor size decreased only by 2% immediately after treatment. Decrease of tumor enhancement after treatment was significant (P < 0.0001) in the arterial phase (69%) as well as in the portal venous phase (64%). After TACE, mean tumor ADC increased by 20% (P = 0.0015), whereas mean nontreated liver, spleen, and muscle ADC values did not change significantly (P = 0.44, P = 0.287, and P = 0.098, respectively). Patient survival from time of first TACE was 21 months for the entire cohort.ConclusionIn patients with leiomyosarcoma and liver metastases who were treated with TACE, significant early changes in the treated lesions occurred on functional MR imaging. These include decrease in tumor enhancement and increase in tumor ADC value, suggesting increasing tumor necrosis and cell death. Changes in tumor size were small and inadequate to assess treatment response, suggesting limitation of the current response criteria in the early assessment of tumor response.

      Pubmed     Full text   Copy Citation     Plaintext  

      Add institutional full text...

    Notes

     
    Knowledge, pearl, summary or comment to share?
    300 characters remaining
    help        
    You can also include formatting, links, images and footnotes in your notes
    • Simple formatting can be added to notes, such as *italics*, _underline_ or **bold**.
    • Superscript can be denoted by <sup>text</sup> and subscript <sub>text</sub>.
    • Numbered or bulleted lists can be created using either numbered lines 1. 2. 3., hyphens - or asterisks *.
    • Links can be included with: [my link to pubmed](http://pubmed.com)
    • Images can be included with: ![alt text](https://bestmedicaljournal.com/study_graph.jpg "Image Title Text")
    • For footnotes use [^1](This is a footnote.) inline.
    • Or use an inline reference [^1] to refer to a longer footnote elseweher in the document [^1]: This is a long footnote..

    hide…