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Functional MRI Evaluation of Tumor Response in Patients with Neuroendocrine Hepatic Metastasis Treated with Transcatheter Arterial Chemoembolization

Eleni Liapi1, Jean-Francois Geschwind, Josephina A. Vossen, Manon Buijs, Christos S. Georgiades, David A. Bluemke and Ihab R. Kamel

1 All authors: Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins Hospital, 601 N Caroline St., Rm. 100, Baltimore, MD 21287.


Figure 1
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  		Fig. 1A —67-year-old woman with hepatic metastasis of neuroendocrine tumor. Changes were seen in contrast enhancement and apparent diffusion coefficient after transcatheter arterial embolization (TACE). MR image (5.1/1.2) in arterial phase of gadolinium enhancement shows 6-cm hypervascular mass (arrow) in left lobe.

 

Figure 2
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  		Fig. 1B —67-year-old woman with hepatic metastasis of neuroendocrine tumor. Changes were seen in contrast enhancement and apparent diffusion coefficient after transcatheter arterial embolization (TACE). MR image (5.1/1.2) in portal venous phase of gadolinium enhancement shows almost complete enhancement of mass (arrow) in left lobe.

 

Figure 3
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  		Fig. 1C —67-year-old woman with hepatic metastasis of neuroendocrine tumor. Changes were seen in contrast enhancement and apparent diffusion coefficient after transcatheter arterial embolization (TACE). Diffusion-weighted MR image (6,500/110) shows hyperintense mass (arrow). Apparent diffusion coefficient is 1.90x10-3 mm2/s.

 

Figure 4
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  		Fig. 1D —67-year-old woman with hepatic metastasis of neuroendocrine tumor. Changes were seen in contrast enhancement and apparent diffusion coefficient after transcatheter arterial embolization (TACE). Unenhanced CT scan of abdomen shows intense deposition of iodized oil in periphery of mass (arrow) after TACE.

 

Figure 5
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  		Fig. 1E —67-year-old woman with hepatic metastasis of neuroendocrine tumor. Changes were seen in contrast enhancement and apparent diffusion coefficient after transcatheter arterial embolization (TACE). MR image (5.1/1.2) in arterial phase of gadolinium enhancement shows mass (arrow) as almost completely avascular after TACE.

 

Figure 6
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  		Fig. 1F —67-year-old woman with hepatic metastasis of neuroendocrine tumor. Changes were seen in contrast enhancement and apparent diffusion coefficient after transcatheter arterial embolization (TACE). MR image (5.1/1.2) in portal venous phase of gadolinium enhancement shows minimal residual peripheral enhancement (< 10%) of mass (arrow) after TACE. Size of mass has only slightly decreased.

 

Figure 7
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  		Fig. 1G —67-year-old woman with hepatic metastasis of neuroendocrine tumor. Changes were seen in contrast enhancement and apparent diffusion coefficient after transcatheter arterial embolization (TACE). Diffusion-weighted MR image (6,500/110) with apparent diffusion coefficient of 2.37 x 10-3 mm2/s confirms increasing cellular necrosis (arrow) after TACE.

 

Figure 8
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  		Fig. 2 —Graph shows Kaplan-Meier survival curve for patients with neuroendocrine tumors managed with transcatheter arterial embolization.

 

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