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. 2008 Oct;60(4):970-5.
doi: 10.1002/mrm.21678.

Four-dimensional transcatheter intraarterial perfusion (TRIP)-MRI for monitoring liver tumor embolization in VX2 rabbits

Dingxin Wang  1 , Sumeet Virmani, Richard Tang, Barbara Szolc-Kowalska, Gayle Woloschak, Reed A Omary, Andrew C Larson
Affiliations

Four-dimensional transcatheter intraarterial perfusion (TRIP)-MRI for monitoring liver tumor embolization in VX2 rabbits

Dingxin Wang et al. Magn Reson Med. 2008 Oct.

Abstract

Transcatheter intraarterial perfusion (TRIP)-MRI is an intraprocedural technique to iteratively monitor liver tumor perfusion changes during transcatheter arterial embolization (TAE) and chemoembolization (TACE). However, previous TRIP-MRI approaches using two-dimensional (2D) T(1)-weighted saturation-recovery gradient-recalled echo (GRE) sequences provided only limited spatial coverage and limited capacity for accurate perfusion quantification. In this preclinical study, a quantitative 4D TRIP-MRI technique (serial iterative 3D volumetric perfusion imaging) with rigorous radiofrequency (RF) B(1) field calibration and dynamic tissue longitudinal relaxation rate R(1) measurement is presented for monitoring intraprocedural liver tumor perfusion during TAE. 4D TRIP-MRI and TAE were performed in five rabbits with eight VX2 liver tumors (N = 8). After B(1) calibrated baseline and dynamic R(1) quantification, subsequent tissue contrast agent concentration time curves were derived. A single-input flow-limited pharmacokinetic model and peak gradient method were applied for perfusion analysis. The perfusion Frho reduced significantly from pre-TAE 0.477 (95% confidence interval [CI]: 0.384-0.570) to post-TAE 0.131 (95% CI: 0.080-0.183 ml/min/ml, P < 0.001).

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Figures

Figure 1
Figure 1
Representative axial MR images in two VX2 liver tumor rabbits (a and b respectively). T2-weighted MR images (top left) show VX2 tumor position (arrows). Pre-embolization static contrast-enhanced T1-weighted MR images (top right), TRIP-MR peak ΔR1 (middle left) and perfusion Fρ (bottom left) maps demonstrate characteristic peripheral hypervascular rim in each VX2 tumor (arrows). Post-embolization TRIP-MR peak ΔR1 (middle right) and perfusion Fρ (bottom right) maps demonstrated reduced contrast agent uptake and perfusion of the tumors in the corresponding regions (arrows). The eight vials positioned around the rabbit were used for T1 calibration. Also notice that in upper rabbit (a) both TRIP-MR peak ΔR1 and perfusion Fρ maps do not depict a small VX2 tumor (X), because this tumor was not located within the vascular territory targeted by IA injection.
Figure 2
Figure 2
Representative Δ[Gd](t) curves for 4 different voxels of a VX2 liver tumor rabbit before and after TAE. The Δ[Gd](t) curve altered in both shape and amplitude for each tumor voxel after TAE.
Figure 3
Figure 3
Graph shows the reduction of quantitative tumor perfusion parameter Fρ after Embosphere® injection in each individual tumor ROI. (p<0.001)
See this image and copyright information in PMC

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