Can Quantitative MRI After cTACE Help Predict Survival ?

Medical College of Wisconsin23 enrolled

Overview

Transcatheter arterial chemoembolization (TACE) is a widely accepted palliative therapy for the treatment of HCC. Palliative means that it does not cure the disease prolongs your life and improves quality of life. During TACE, a mixture of chemotherapy drugs is combined with an oil called lipiodol. Lipiodol has a role as both drug carrier and embolic agent (a material that blocks blood flow to tumors). The lipiodol/chemotherapy mixture is injected into an artery (blood vessel) directly supplying blood to a HCC tumor. Lipiodol is made up of fat and water which can be seen on MRI. Therefore, MRI can be used to quantify the amount of lipiodol delivered to the HCC tumors. In this study, the investigators want to see if patient survival is related to the amount of lipiodol delivered to HCC tumors.

Study Type

OBSERVATIONAL

Enrollment

Conditions

Hepatocellular Carcinoma (HCC)

Interventions

MRI post-TACEOTHER

Perform lipiodol delivery measurements with MRI post-TACE.

Eligibility

Medical Language ↔ Plain English

Inclusion Criteria: * Prospective studies will be performed in 20 patients with Hepatocellular Carcinoma (HCC) independently scheduled to undergo TACE; tumors in each of these candidates will already have been deemed un-resectable. * Reasons may include * concurrent co-morbidities including cardiac or respiratory compromise * recurrent or multi-lobar disease * cirrhosis or portal hypertension * vascular invasion * high tumor burden * contraindications to general anesthesia. * Diagnosis of HCC will have been established by a) biopsy or b) non-invasively, based upon \> 2cm diameter tumor with characteristic imaging findings in the setting of cirrhosis. * Male or female aged 18 to 89 years, all ethnicities Exclusion Criteria: * Infiltrative or diffuse HCC. * Does not meet inclusion criteria. * Pregnant women. * Individuals with pacemakers or other non-MRI compatible metallic implants. * Hemodialysis patients or patients with severely impaired renal function. * Individuals with severe claustrophobia or unwilling to get a MRI.

Outcomes

Primary Outcomes

Imaging response

Imaging response will be assessed according to 3D European Association for the Study of the Liver (EASL) criteria. EASL criteria propose using contrast enhanced (CE) images to measure viable volumes. We will transfer all images to a computer workstation. We will measure 'viable' enhancing tumor volumes at each interval and percent change in viable tumor volume (change from baseline). We will correlate lipiodol delivery measurements to primary outcomes post-therapy.