THERAPEUTIC EFFICACY OF TRANSCATHETER ARTERIAL CHEMOEMBOLIZATION FOR HEPATOCELLULAR-CARCINOMA - MRI AND PATHOLOGY

Objective: Our goal was to evaluate the usefulness of multisection dyn amic MRI with gadopentetate dimeglumine in the assessment of the thera peutic efficacy of transcatheter arterial chemoembolization (TAE) with iodized oil for hepatocellular carcinomas (HCCs). Materials and Metho ds: Findings on multisection dynamic MR images were compared with gros s appearance and histologic findings in 13 patients with HCCs after TA E with iodized oil. Arterial dominant phase images of the entire liver were obtained 20 s after the start of administration of gadopentetate dimeglumine.Results: In 3 of the 13 patients, no enhancing areas with in the tumors were detected. In the remaining 10 patients, enhancing p ortions were detected within the tumor on arterial dominant phase imag es. Histologically, viable tumor cells were present in the rapidly enh ancing portions, while necrotic tissues were present in nonenhancing a reas, irrespective of the accumulation of iodized oil on CT scans. How ever, in one patient in whom no enhancing portion was seen in the tumo r, a small number of viable tumor cells within the capsule were identi fied on pathologic examination. Conclusion: Multisection dynamic MRI i s helpful for evaluating the therapeutic efficacy of TAE with iodized oil for HCCs by revealing the hemodynamics of the tumor irrespective o f accumulation of iodized oil.