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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.



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  		Fig. 1. —Graph shows enhancement ratio on slow-infusion MR arteriography. Ranges (vertical lines) indicate standard deviation of mean. In most patients, enhancement of liver tumor ({diamondsuit}) exceeded that of liver parenchyma ({blacksquare}), kidney (•), spleen (x), and pancreas body ({blacktriangleup}) during phase 2 (10-20 min).

 


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  		Fig. 2A. —Liver metastases from sigmoid colon cancer in 48-year-old man. Slow-infusion MR arteriogram obtained during phase 1 shows slight enhancement of liver tumor (arrow).

 


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  		Fig. 2B. —Liver metastases from sigmoid colon cancer in 48-year-old man. Slow-infusion MR arteriograms obtained during phase 2 (B) and phase 3 (C) show that enhancement of liver tumor (arrow) is greater than that of liver parenchyma. Kidney is significantly enhanced in phase 3 image compared with phase 2 image.

 


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  		Fig. 2C. —Liver metastases from sigmoid colon cancer in 48-year-old man. Slow-infusion MR arteriograms obtained during phase 2 (B) and phase 3 (C) show that enhancement of liver tumor (arrow) is greater than that of liver parenchyma. Kidney is significantly enhanced in phase 3 image compared with phase 2 image.

 


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  		Fig. 3A. —Liver metastases from breast cancer in 49-year-old woman. CT arteriogram reveals homogeneous distribution of hepatic parenchyma.

 


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  		Fig. 3B. —Liver metastases from breast cancer in 49-year-old woman. Slow-infusion MR arteriogram obtained during phase 2 shows lobar hyperperfusion of right hepatic lobe (arrows).

 


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  		Fig. 4A. —Liver metastases from sigmoid colon cancer in 61-year-old woman. CT arteriogram shows segmental hyperperfusion of right posterior segment of liver (arrows).

 


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  		Fig. 4B. —Liver metastases from sigmoid colon cancer in 61-year-old woman. Slow-infusion MR arteriogram obtained during phase 2 shows homogeneous distribution in liver.

 


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  		Fig. 5A. —Liver metastases from rectal cancer in 65-year-old woman with gastroduodenal toxicity. On CT arteriogram, imaging artifacts (arrows) caused by platinum coils in gastroduodenal artery are too strong to evaluate perfusion in area around coils.

 


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  		Fig. 5B. —Liver metastases from rectal cancer in 65-year-old woman with gastroduodenal toxicity. Slow-infusion MR arteriogram obtained during phase 2 reveals enhancement of duodenum and pancreas head (arrows). Platinum coils (arrowhead) can be seen as signal loss.

 


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  		Fig. 6A. —Liver metastases from ascending colon cancer in 66-year-old woman with no clinical problem during treatment. CT arteriogram shows enhancement of duodenal wall and pancreas head (arrows).

 


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  		Fig. 6B. —Liver metastases from ascending colon cancer in 66-year-old woman with no clinical problem during treatment. On slow-infusion MR arteriogram obtained during phase 2, no enhancement can be seen in this area.

 

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