Modern chemo treatment for liver tumors requires monitoring how the therapy is affecting the tumors. This is typically done by measuring the size of the tumors from 2D scans, but this can be misleading because this doesn’t reveal whether the tumor cells are dead or alive and what is the actual three dimensional shape of the tumor.
A new technique developed at Johns Hopkins and being presented at the ongoing Society of Interventional Radiology’s annual meeting in San Diego provides a volumetric view of the neoplasm while showing which regions are dead or dying. It relies on injecting an MRI contrast agent while monitoring how fast it is absorbed into the tumor cells. Because live cells absorb the contrast more readily than dead or dying ones, they can be imaged and categorized into a comprehensive 3D view of how the tumor is doing.
More about the technology and findings from a Hopkins press release:
In the first study, researchers compared the standard imaging method and the newly developed technology in 17 Baltimore men and women with advanced liver cancer. All were treated with surgery or liver transplantation after chemoembolization. The research team used existing MR analysis techniques, as well as the new 3-D method to compare the radiologists’ analyses with pathologic review of tumor samples after therapy and surgical removal. The error margin of the new 3-D image analysis, they say, was low (at up to 10 percent) when predicting the amount of dead tumor tissue found by pathologists whereas the standard, 2-D method deviated by as much as 40 percent from actual values.
In a series of additional studies, Geschwind and his team used the standard and new imaging techniques to analyze the MRI scans of more than 300 liver tumors in some 123 other men and women, also from the Baltimore region. All patients were treated at The Johns Hopkins Hospital between 2003 and 2012, and each received pre- and post-chemoembolization MRI scans to assess the effects of therapy on the tumors.
Using the new 3-D method method, Geschwind’s team found that patients who responded well to therapy lived 19 months longer (an average of 42 months) than patients who did not respond well (average 23 month survival). Standard methods showed slightly less difference in survival (average 18 months longer) between patients who responded to therapy and those who did not respond.
Geschwind says the 3-D technology’s improved accuracy removes a lot of the guesswork that now goes into evaluating treatment outcomes. The new assessment takes seconds to perform, he adds, so radiologists can provide faster, almost instantaneous treatment advice.