Perfusion magnetic resonance imaging of the liver

    Publication Date
    Source Authors
    Source Title
    Source Issue
    Publication Date

    2017

    Source Authors

    • Choon Hua Thng,
    • Tong San Koh,
    • David J Collins,
    • Dow Mu Koh

    Source Title

    Perfusion magnetic resonance imaging of the liver

    Source Issue

    World Journal of Gastroenterology

    vol. 16, issue 13

    Page Range: 1598-1609

    L’articolo si riferisce alla diagnosi delle patologie epatiche, tramite utilizzo di nuove metodiche di studio come l’MRI di perfusione e la sua efficacia. Gli studi di imaging (MRI Perfussion) ci consentono di quantificare lo stato micro-circolatorio del parenchima epatico, evidenziando lesioni epatiche, essere utilizzate per la rilevazione di metastasi epatiche, valutazione dell’efficacia della terapia anti-angiogenica, valutazione della vitalità del tumore dopo terapia o ablazione antitumorale, diagnosi della cirrosi epatica e della sua gravità. Tale elaborato risalta la gestione autonoma e responsabile della suddetta attività di verifica e controllo dei pazienti affetti delle anzidette patologie epatiche. Inoltre quest’articolo ci offre un’ottima discussione dei concetti di base in MRI mediante modellazione cinetica del tracciante, le tecniche di scansione, le metodiche di elaborazione dei dati, e in fine evidenzia le prove che ne supportano l’uso di tale metodica tramite gli esami clinici pubblicati e studi di ricerca.
    Il tema cardine del brano, tratta la capacita di dare una corretta diagnosi con i mezzi di imaging non invasivo ad oggi a disposizione. In quanto quest’ultime, costituiscono una rilevante risorsa perché sono in rapida evoluzione e possono sostituire le datate tecniche d’imaging, che in alcuni casi possono portare ad una non corretta diagnosi. Queste problematiche, infatti, rappresentano la complicanza in assoluto più frequente in quest’ambito. Il suddetto prodotto ci indica la possibilità di usufruire di questi metodi che includono tecniche di imaging non invasivo, che ad oggi sono più che consolidate.
    Il brano si suddivide in più parti, inizialmente viene mostrata la tematica dell’argomento al fine di aumentarne la conoscenza, ed i relativi rischi ad esse associate. In prosecuzione viene sviluppato il tema centrale con i relativi obiettivi che si prefigge. Successivamente vengono evidenziati gli obiettivi che tale tematica intende raggiungere, vengono illustrate le varie tecniche e le sue applicazioni. Evidenziando gli avanzamenti tecnologici e metodologici in MRI Perfusion, che portino alla standardizzazione di tale tecnica e gli ulteriori studi aiuteranno sicuramente a stabilire e validare la perfusione RM come modalità di imaging clinico.

    REFERENCES

    1 Leggett DA, Kelley BB, Bunce IH, Miles KA. Colorectal cancer: diagnostic potential of CT measurements of hepatic perfusion and implications for contrast enhancement protocols. Radiology 1997; 205: 716-720

    2 Miles KA, Hayball MP, Dixon AK. Functional images of hepatic perfusion obtained with dynamic CT. Radiology 1993; 188: 405-411

    3 Blomley MJ, Coulden R, Dawson P, Kormano M, Donlan P, Bufkin C, Lipton MJ. Liver perfusion studied with ultrafast CT. J Comput Assist Tomogr 1995; 19: 424-433

    4 Koh TS, Thng CH, Hartono S, Lee PS, Choo SP, Poon DY, Toh HC, Bisdas S. Dynamic contrast-enhanced CT imaging of hepatocellular carcinoma in cirrhosis: feasibility of a prolonged dual-phase imaging protocol with tracer kinetics WJG|www.wjgnet.com 1607 April modeling. Eur Radiol 2009; 19: 1184-1196

    5 Hashimoto K, Murakami T, Dono K, Hori M, Kim T, Kudo M, Marubashi S, Miyamoto A, Takeda Y, Nagano H, Umeshita K, Nakamura H, Monden M. Assessment of the severity of liver disease and fibrotic change: the usefulness of hepatic CT perfusion imaging. Oncol Rep 2006; 16: 677-683

    6 Annet L, Materne R, Danse E, Jamart J, Horsmans Y, Van Beers BE. Hepatic flow parameters measured with MR imaging and Doppler US: correlations with degree of cirrhosis and portal hypertension. Radiology 2003; 229: 409-414

    7 Van Beers BE, Leconte I, Materne R, Smith AM, Jamart J, Horsmans Y. Hepatic perfusion parameters in chronic liver disease: dynamic CT measurements correlated with disease severity. AJR Am J Roentgenol 2001; 176: 667-673

    8 Hagiwara M, Rusinek H, Lee VS, Losada M, Bannan MA, Krinsky GA, Taouli B. Advanced liver fibrosis: diagnosis with 3D whole-liver perfusion MR imaging–initial experience. Radiology 2008; 246: 926-934

    9 Chiandussi L, Greco F, Sardi G, Vaccarino A, Ferraris CM, Curti B. Estimation of hepatic arterial and portal venous blood flow by direct catheterization of the vena porta through the umbilical cord in man. Preliminary results. Acta Hepatosplenol 1968; 15: 166-171

    10 Pandharipande PV, Krinsky GA, Rusinek H, Lee VS. Perfusion imaging of the liver: current challenges and future goals. Radiology 2005; 234: 661-673

    11 Villeneuve JP, Dagenais M, Huet PM, Roy A, Lapointe R, Marleau D. The hepatic microcirculation in the isolated perfused human liver. Hepatology 1996; 23: 24-31

    12 Liu Y, Matsui O. Changes of intratumoral microvessels and blood perfusion during establishment of hepatic metastases in mice. Radiology 2007; 243: 386-395

    13 Terayama N, Terada T, Nakanuma Y. An immunohistochemical study of tumour vessels in metastatic liver cancers and the surrounding liver tissue. Histopathology 1996; 29: 37-43

    14 Nakanuma Y, Terada T, Terasaki S, Ueda K, Nonomura A, Kawahara E, Matsui O. ‘Atypical adenomatous hyperplasia’ in liver cirrhosis: low-grade hepatocellular carcinoma or borderline lesion? Histopathology 1990; 17: 27-35

    15 Hayashi M, Matsui O, Ueda K, Kawamori Y, Gabata T, Kadoya M. Progression to hypervascular hepatocellular carcinoma: correlation with intranodular blood supply evaluated with CT during intraarterial injection of contrast material. Radiology 2002; 225: 143-149

    16 Wang HZ, Riederer SJ, Lee JN. Optimizing the precision in T1 relaxation estimation using limited flip angles. Magn Reson Med 1987; 5: 399-416

    17 Orton MR, Miyazaki K, Koh DM, Collins DJ, Hawkes DJ, Atkinson D, Leach MO. Optimizing functional parameter accuracy for breath-hold DCE-MRI of liver tumours. Phys Med Biol 2009; 54: 2197-2215

    18 Jackson A, Haroon H, Zhu XP, Li KL, Thacker NA, Jayson G. Breath-hold perfusion and permeability mapping of hepatic malignancies using magnetic resonance imaging and a firstpass leakage profile model. NMR Biomed 2002; 15: 164-173

    19 Tsushima Y, Blomley MJ, Kusano S, Endo K. Measuring portal venous perfusion with contrast-enhanced CT: comparison of direct and indirect methods. Acad Radiol 2002; 9: 276-282

    20 Koh TS, Thng CH, Lee PS, Hartono S, Rumpel H, Goh BC, Bisdas S. Hepatic metastases: in vivo assessment of perfusion parameters at dynamic contrast-enhanced MR imaging with dual-input two-compartment tracer kinetics model. Radiology 2008; 249: 307-320

    21 Tofts PS, Brix G, Buckley DL, Evelhoch JL, Henderson E, Knopp MV, Larsson HB, Lee TY, Mayr NA, Parker GJ, Port RE, Taylor J, Weisskoff RM. Estimating kinetic parameters from dynamic contrast-enhanced T(1)-weighted MRI of a diffusable tracer: standardized quantities and symbols. J Magn Reson Imaging 1999; 10: 223-232

    22 Totman JJ, O’gorman RL, Kane PA, Karani JB. Comparison of the hepatic perfusion index measured with gadoliniumenhanced volumetric MRI in controls and in patients with colorectal cancer. Br J Radiol 2005; 78: 105-109

    23 Tsushima Y, Blomley MJ, Yokoyama H, Kusano S, Endo K. Does the presence of distant and local malignancy alter parenchymal perfusion in apparently disease-free areas of the liver? Dig Dis Sci 2001; 46: 2113-2119

    24 Warren HW, Gallagher H, Hemingway DM, Angerson WJ, Bessent RG, Wotherspoon H, McArdle CS, Cooke TG. Prospective assessment of the hepatic perfusion index in patients with colorectal cancer. Br J Surg 1998; 85: 1708-1712

    25 Ballantyne KC, Charnley RM, Perkins AC, Pye G, Whalley DR, Wastie ML, Hardcastle JD. Hepatic perfusion index in the diagnosis of overt metastatic colorectal cancer. Nucl Med Commun 1990; 11: 23-28

    26 Meijerink MR, van Waesberghe JH, van der Weide L, van den Tol P, Meijer S, van Kuijk C. Total-liver-volume perfusion CT using 3-D image fusion to improve detection and characterization of liver metastases. Eur Radiol 2008; 18: 2345-2354

    27 Cuenod C, Leconte I, Siauve N, Resten A, Dromain C, Poulet B, Frouin F, Clément O, Frija G. Early changes in liver perfusion caused by occult metastases in rats: detection with quantitative CT. Radiology 2001; 218: 556-561

    28 Abdullah SS, Pialat JB, Wiart M, Duboeuf F, Mabrut JY, Bancel B, Rode A, Ducerf C, Baulieux J, Berthezene Y. Characterization of hepatocellular carcinoma and colorectal liver metastasis by means of perfusion MRI. J Magn Reson Imaging 2008; 28: 390-395

    29 Fournier LS, Cuenod CA, de Bazelaire C, Siauve N, Rosty C, Tran PL, Frija G, Clement O. Early modifications of hepatic perfusion measured by functional CT in a rat model of hepatocellular carcinoma using a blood pool contrast agent. Eur Radiol 2004; 14: 2125-2133

    30 Sahani DV, Holalkere NS, Mueller PR, Zhu AX. Advanced hepatocellular carcinoma: CT perfusion of liver and tumor tissue–initial experience. Radiology 2007; 243: 736-743

    31 Matsui O, Kadoya M, Kameyama T, Yoshikawa J, Takashima T, Nakanuma Y, Unoura M, Kobayashi K, Izumi R, Ida M. Benign and malignant nodules in cirrhotic livers: distinction based on blood supply. Radiology 1991; 178: 493-497

    32 Sijens PE. Parametric exploration of the liver by magnetic resonance methods. Eur Radiol 2009; 19: 2594-2607

    33 Eisenhauer EA, Therasse P, Bogaerts J, Schwartz LH, Sargent D, Ford R, Dancey J, Arbuck S, Gwyther S, Mooney M, Rubinstein L, Shankar L, Dodd L, Kaplan R, Lacombe D, Verweij J. New response evaluation criteria in solid tumours: revised RECIST guideline (version 1.1). Eur J Cancer 2009; 45: 228-247

    34 Llovet JM, Di Bisceglie AM, Bruix J, Kramer BS, Lencioni R, Zhu AX, Sherman M, Schwartz M, Lotze M, Talwalkar J, Gores GJ. Design and endpoints of clinical trials in hepatocellular carcinoma. J Natl Cancer Inst 2008; 100: 698-711

    35 Bruix J, Sherman M. Management of hepatocellular carcinoma. Hepatology 2005; 42: 1208-1236

    36 Bruix J, Sherman M, Llovet JM, Beaugrand M, Lencioni R, Burroughs AK, Christensen E, Pagliaro L, Colombo M, Rodés J. Clinical management of hepatocellular carcinoma. Conclusions of the Barcelona-2000 EASL conference. European Association for the Study of the Liver. J Hepatol 2001; 35: 421-430

    37 Prokop M. CT and MR to assess the response of liver tumors to hepatic perfusion. Recent Results Cancer Res 1998; 147: 136-154

    38 Wang J, Chen LT, Tsang YM, Liu TW, Shih TT. Dynamic contrast-enhanced MRI analysis of perfusion changes in advanced hepatocellular carcinoma treated with an antiangiogenic agent: a preliminary study. AJR Am J Roentgenol 2004; 183: 713-719

    39 Miyazaki K, Collins DJ, Walker-Samuel S, Taylor JN, Padhani AR, Leach MO, Koh DM. Quantitative mapping of hepatic perfusion index using MR imaging: a potential reproducible tool for assessing tumour response to treatment with the antiangiogenic compound BIBF 1120, a potent triple angiokinase inhibitor. Eur Radiol 2008; 18: 1414-1421

    40 Meijerink MR, van Cruijsen H, Hoekman K, Kater M, vanSchaik C, van Waesberghe JH, Giaccone G, Manoliu RA. The use of perfusion CT for the evaluation of therapy combining AZD2171 with gefitinib in cancer patients. Eur Radiol 2007; 17: 1700-1713

    41 Meijerink MR, van Waesberghe JH, van der Weide L, van den Tol P, Meijer S, Comans EF, Golding RP, van Kuijk C. Early detection of local RFA site recurrence using total liver volume perfusion CT initial experience. Acad Radiol 2009; 16: 1215-1222

    42 Chen G, Ma DQ, He W, Zhang BF, Zhao LQ. Computed tomography perfusion in evaluating the therapeutic effect of transarterial chemoembolization for hepatocellular carcinoma. World J Gastroenterol 2008; 14: 5738-5743

    43 Bolton RP, Mairiang EO, Parkin A, Ware F, Robinson P, Losowsky MS. Dynamic liver scanning in cirrhosis. Nucl Med Commun 1988; 9: 235-247

    44 Guan S, Zhao WD, Zhou KR, Peng WJ, Mao J, Tang F. CTperfusion at early stage of hepatic diffuse disease. World J Gastroenterol 2005; 11: 3465-3467

    45 Materne R, Annet L, Dechambre S, Sempoux C, Smith AM, Corot C, Horsmans Y, Van Beers BE. Dynamic computed tomography with low- and high-molecular-mass contrast agents to assess microvascular permeability modifications in a model of liver fibrosis. Clin Sci (Lond) 2002; 103: 213-216

    46 Materne R, Van Beers BE, Smith AM, Leconte I, Jamart J, Dehoux JP, Keyeux A, Horsmans Y. Non-invasive quantification of liver perfusion with dynamic computed tomography and a dual-input one-compartmental model. Clin Sci (Lond) 2000; 99: 517-525

    47 Materne R, Smith AM, Peeters F, Dehoux JP, Keyeux A, Horsmans Y, Van Beers BE. Assessment of hepatic perfusion parameters with dynamic MRI. Magn Reson Med 2002; 47: 135-142

    48 Scharf J, Zapletal C, Hess T, Hoffmann U, Mehrabi A, Mihm D, Hoffmann V, Brix G, Kraus T, Richter GM, Klar E. Assessment of hepatic perfusion in pigs by pharmacokinetic analysis of dynamic MR images. J Magn Reson Imaging 1999; 9: 568-572

    49 Cuenod CA, Leconte I, Siauve N, Frouin F, Dromain C, Clément O, Frija G. Deconvolution technique for measuring tissue perfusion by dynamic CT: application to normal and metastatic liver. Acad Radiol 2002; 9 Suppl 1: S205-S211

    50 Funabasama S, Tsushima Y, Sanada S, Inoue K.[ Hepatic perfusion CT imaging analyzed by the dual-input onecompartment model] Nippon Hoshasen Gijutsu Gakkai Zasshi 2003; 59: 1548-1554

    51 Miyazaki S, Murase K, Yoshikawa T, Morimoto S, Ohno Y, Sugimura K. A quantitative method for estimating hepatic blood flow using a dual-input single-compartment model. Br J Radiol 2008; 81: 790-800

    52 Lee TY, Purdie TG, Stewart E. CT imaging of angiogenesis. Q J Nucl Med 2003; 47: 171-187

    53 St Lawrence KS, Lee TY. An adiabatic approximation to the tissue homogeneity model for water exchange in the brain: I. Theoretical derivation. J Cereb Blood Flow Metab 1998; 18: 1365-1377