Liver Cancer
Copyright ©The Author(s) 2004. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. May 15, 2004; 10(10): 1415-1420
Published online May 15, 2004. doi: 10.3748/wjg.v10.i10.1415
Changes of tumor microcirculation after transcatheter arterial chemoembolization: First pass perfusion MR imaging and Chinese ink casting in a rabbit model
Jun-Gong Zhao, Gan-Sheng Feng, Xiang-Quan Kong, Xin Li, Ming-Hua Li, Ying-Sheng Cheng
Jun-Gong Zhao, Ming-Hua Li, Ying-Sheng Cheng, Department of Radiology, Sixth Affiliated Hospital of Shanghai Jiaotong University, Shanghai 200233, China
Gan-Sheng Feng, Xiang-Quan Kong, Xin Li, Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, Hubei Province, China
Author contributions: All authors contributed equally to the work.
Correspondence to: Dr. Jun-Gong Zhao, Department of Radiology, Sixth Affiliated Hospital of Shanghai Jiaotong University, Shanghai 200233, China. zhaojun_gong@sohu.com
Telephone: +86-21-64369181 Ext 8882
Received: September 9, 2003
Revised: October 15, 2003
Accepted: October 22, 2003
Published online: May 15, 2004
Abstract

AIM: To observe the change of tumor microcirculation after transcatheter arterial chemoembolization (TACE) with bletilla microspheres by using first pass perfusion MR imaging (FP) and Chinese ink casting.

METHODS: VX2 carcinoma cells were surgically implanted into the left and right lobes of liver of 30 New Zealand white rabbits, which were divided into 3 groups at random. Emulsion of lipiodol mixed with mitomycin C, and 5-FU bletilla microspheres were injected into the hepatic artery respectively, and saline was used as control agent. MR imaging was performed with turbo-flash sequence 14 d after tumor implantation and 7 d after interventional therapy. The steepest slopes (SS) of the signal intensity versus time curves were created for quantitative analysis, 7.5% Chinese ink gelatin solution was injected through ascending artery (17 cases) or portal vein (2 cases) for lesion microvessel area (MVA) measurement after the last MRI examination.The correlation between perfusion imaging and MVA was studied blindly.

RESULTS: The SS values at the rim of tumor in lipiodol group (mean, 49% per second) and bletilla group (mean, 35% per second) were significantly decreased (P < 0.05) as compared with control group (mean, 124% per second), no difference was found between lipiodol and bletilla groups (P > 0.05). In lipiodol group, the MVAs (24974 ± 11836 μm2) in the center of the tumor were significantly smaller than those of the control group (35510 ± 15675 μm2) (P < 0.05), while the MVAs (80031 ± 22745 μm2) around the tumor were significantly increased because small and dense plexuses appeared around the tumor which correlated to intense reaction of granulation tissue. None of the vessels was seen in the tumor in bletilla group, the peripheral MVAs of the tumor were significantly smaller than those of the control group (P < 0.05) and lipiodol group (P < 0.05). There was a good correlation between SS and MVAs in control group (rs, 0.985, P < 0.0001) and bletilla group (rs, 0.743, P < 0.05), the correlation was not significant in lipiodol group (rs, 0.527, P > 0.05).

CONCLUSION: TACE with bletilla microspheres may enhance its anti-tumor effect by inhibiting the angiogenesis, and FP-MRI provides useful information to assess the TACE effect by depicting tumor vascularization and perfusion.

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