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AJR 2003; 180:681-686
© American Roentgen Ray Society

Using Slow-Infusion MR Arteriography and an Implantable Port System to Assess Drug Distribution at Hepatic Arterial Infusion Chemotherapy

Hiroshi Seki1, Toshirou Ozaki2, Satoshi Takaki2, Hiroyuki Ooi2, Junichi Oda1 and Makoto Shiina1

1 Department of Radiology, Niigata Cancer Center Hospital, 2-15-3, Kawagishi-cho, Niigata 951-8566, Japan.
2 Division of Radiation Oncology, Department of Molecular Genetics, Course for Molecular and Cellular Medicine, Niigata University Graduate School of Medical and Dental Sciences, 757, 1-bancho, Asahimachi-dori, Niigata 951-8510, Japan.

OBJECTIVE. The purpose of this study was to assess perfusion patterns seen on slow-infusion MR arteriography using the hepatic arterial infusion system compared with those seen on CT arteriography.

SUBJECTS AND METHODS. In 37 patients with liver metastases who had implantable port systems for hepatic arterial infusion chemotherapy, slow-infusion MR arteriography using an infusion rate of 10 mL/hr through an implantable port and CT arteriography using an injection rate of 0.7 mL/sec were performed. In 15 of 37 patients, we evaluated enhancement patterns of tumors of the liver and visceral organs using slow-infusion MR arteriography. In all 37 patients, we compared slow-infusion MR arteriography with CT arteriography concerning intra- and extrahepatic perfusion patterns.

RESULTS. On slow-infusion MR arteriography performed 10-20 min after initiation of infusion, tumors of the liver revealed significant enhancement with only a slight effect of systemic enhancement. In seven (19%) of 37 patients, intrahepatic distributions on slow-infusion MR arteriography differed from those on CT arteriography. In eight patients, the patterns of extrahepatic perfusion into the duodenum and the pancreas head differed on slow-infusion MR arteriography from those seen on CT arteriography. In addition, strong artifact caused by platinum coils in the gastroduodenal artery interfered with the evaluation of perfusion in the area around the coils on CT arteriography, whereas no imaging artifact was seen on slow-infusion MR arteriography.

CONCLUSION. We believe that slow-infusion MR arteriography reflects the actual distribution of infused drugs more accurately than CT arteriography. When clinical complications occur during treatment, slow-infusion MR arteriography should be used to assess perfusion abnormalities.


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