A comparison of chemoembolization endpoints using angiographic versus transcatheter intraarterial perfusion/MR imaging monitoring.

A comparison of chemoembolization endpoints using angiographic versus transcatheter intraarterial perfusion/MR imaging monitoring. Research Abstract Details 

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A comparison of chemoembolization endpoints using angiographic versus transcatheter intraarterial perfusion/MR imaging monitoring. Abstract Text:

Robert J Lewandowski,Dingxin Wang,James Gehl,Bassel Atassi,Robert K Ryu,Kent Sato,Albert A Nemcek,Frank H Miller,Mary F Mulcahy,Laura Kulik,Andrew C Larson,Riad Salem,Reed A Omary,Robert J Lewandowski,Dingxin Wang,James Gehl,Bassel Atassi,Robert K Ryu,Kent Sato,Albert A Nemcek,Frank H Miller,Mary F Mulcahy,Laura Kulik,Andrew C Larson,Riad Salem,Reed A Omary,

PURPOSE: Transcatheter arterial chemoembolization (TACE) is an established treatment for unresectable liver cancer. This study was conducted to test the hypothesis that angiographic endpoints during TACE are measurable and reproducible by comparing subjective angiographic versus objective magnetic resonance (MR) endpoints of TACE. MATERIALS AND METHODS: The study included 12 consecutive patients who presented for TACE for surgically unresectable HCC or progressive hepatic metastases despite chemotherapy. All procedures were performed with a dedicated imaging system. Angiographic series before and after TACE were reviewed independently by three board-certified interventional radiologists. A subjective angiographic chemoembolization endpoint (SACE) classification scheme, modified from an established angiographic grading system in the cardiology literature, was designed to assist in reproducibly classifying angiographic endpoints. Reproducibility in SACE classification level was compared among operators, and MR imaging perfusion reduction was compared with SACE levels for each observer. RESULTS: Twelve patients successfully underwent 15 separate TACE sessions. SACE levels ranged from I through IV. There was moderate agreement in SACE classification (kappa = 0.46 +/- 0.12). There was no correlation between SACE level and MR perfusion reduction (r = 0.16 for one operator and 0.02 for the other two). CONCLUSIONS: Angiographic endpoints during TACE vary widely, have moderate reproducibility among operators, and do not correlate with functional MR imaging perfusion endpoints. Future research should aim to determine ideal angiographic and functional MR imaging endpoints for TACE according to outcome measures such as imaging response, pathologic response, and survival.

A comparison of chemoembolization endpoints using angiographic versus transcatheter intraarterial perfusion/MR imaging monitoring. Publishing Authors By Initials

RJ Lewandowski,D Wang,J Gehl,B Atassi,RK Ryu,K Sato,AA Nemcek,FH Miller,MF Mulcahy,L Kulik,AC Larson,R Salem,RA Omary,RJ Lewandowski,D Wang,J Gehl,B Atassi,RK Ryu,K Sato,AA Nemcek,FH Miller,MF Mulcahy,L Kulik,AC Larson,R Salem,RA Omary,

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A comparison of chemoembolization endpoints using angiographic versus transcatheter intraarterial perfusion/MR imaging monitoring. Journal Published:

PUBLICATION TYPE: Journal Article

Journal: Journal of vascular and interventional radiology :

VOLUME: 18

Page Numbers: 1249-57

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ISSN: 1051-0443

DAY: 3

MONTH: Oct

YEAR: 2007

A comparison of chemoembolization endpoints using angiographic versus transcatheter intraarterial perfusion/MR imaging monitoring. Information

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LANGUAGE: eng

NlmUniqueID: 9203369

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AFFILIATION: Department of Radiology, Northwestern University, 676 North St. Clair Street, Suite 800, Chicago, Illinois 60611, USA. r-lewandowski@northwestern.edu

Country: United States

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MEDLINETA: J Vasc Interv Radiol

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