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

Objective: Our goal was to evaluate the usefulness of multisection dynamic MRI with gadopentetate dimeglumine in the assessment of the therapeutic efficacy of transcatheter arterial chemoembolization (TAE) with iodized oil for hepatocellular carcinomas (HCCs). Materials and Methods: Findings on multisection dynamic MR images were compared with gross appearance and histologic findings in 13 patients with HCCs after TAE 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 within the tumors were detected. In the remaining 10 patients, enhancing portions were detected within the tumor on arterial dominant phase images. Histologically, viable tumor cells were present in the rapidly enhancing portions, while necrotic tissues were present in nonenhancing areas, irrespective of the accumulation of iodized oil on CT scans. However, in one patient in whom no enhancing portion was seen in the tumor, a small number of viable tumor cells within the capsule were identified on pathologic examination. Conclusion: Multisection dynamic MRI is helpful for evaluating the therapeutic efficacy of TAE with iodized oil for HCCs by revealing the hemodynamics of the tumor irrespective of accumulation of iodized oil.