DCE-MRI in hepatocellular carcinoma-clinical and therapeutic image biomarker
Journal
World Journal of Gastroenterology
Journal Volume
20
Journal Issue
12
Pages
3125-3134
Date Issued
2014
Author(s)
Abstract
Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) enables tumor vascular physiology to be assessed. Within the tumor tissue, contrast agents (gadolinium chelates) extravasate from intravascular into the extravascular extracellular space (EES), which results in a signal increase on T1-weighted MRI. The rate of contrast agents extravasation to EES in the tumor tissue is determined by vessel leakiness and blood flow. Thus, the signal measured on DCE-MRI represents a combination of permeability and per-fusion. The semi-quantitative analysis is based on the calculation of heuristic parameters that can be extracted from signal intensity-time curves. These enhancing curves can also be deconvoluted by mathematical modeling to extract quantitative parameters that may reflect tumor perfusion, vascular volume, vessel permeability and angiogenesis. Because hepatocel-lular carcinoma (HCC) is a hypervascular tumor, many emerging therapies focused on the inhibition of angio-genesis. DCE-MRI combined with a pharmacokinetic model allows us to produce highly reproducible and reliable parametric maps of quantitative parameters in HCC. Successful therapies change quantitative parameters of DCE-MRI, which may be used as early indicators of tumor response to anti-angiogenesis agents that modulate tumor vasculature. In the setting of clinical trials, DCE-MRI may provide relevant clinical information on the pharmacodynamic and biologic effects of novel drugs, monitor treatment response and predict survival outcome in HCC patients. ? 2014 Baishideng Publishing Group Co., Limited. All rights reserved.
SDGs
Other Subjects
bevacizumab; biological marker; dexamethasone; floxuridine; sorafenib; sunitinib; thalidomide; vandetanib; vasculotropin; angiogenesis inhibitor; contrast medium; gadolinium pentetate; tumor marker; angiogenesis; article; blood vessel permeability; cancer specific survival; clinical trial (topic); computer assisted tomography; diagnostic imaging; disease course; dynamic contrast enhanced magnetic resonance imaging; experimental model; extravascular extracellular space; human; liver cell carcinoma; overall survival; quantitative analysis; radiodiagnosis; tissue perfusion; treatment response; tumor blood flow; tumor invasion; tumor microenvironment; tumor vascularization; vascular tumor; diagnostic use; image enhancement; liver; liver cell carcinoma; liver tumor; neovascularization (pathology); nuclear magnetic resonance imaging; pathology; perfusion; permeability; procedures; theoretical model; treatment outcome; Angiogenesis Inhibitors; Carcinoma, Hepatocellular; Clinical Trials as Topic; Contrast Media; Gadolinium DTPA; Humans; Image Enhancement; Liver; Liver Neoplasms; Magnetic Resonance Imaging; Models, Theoretical; Neovascularization, Pathologic; Perfusion; Permeability; Treatment Outcome; Tumor Markers, Biological
Type
journal article