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Persistent T2*‐hypointensity of the liver parenchyma after irradiation to the SPIO‐accumulated liver: An imaging marker for responses to radiotherapy in hepatic malignancies
Author(s) -
Furuta Toshihiro,
Yamaguchi Masayuki,
Minami Manabu,
Ohtomo Kuni,
Fujii Hirofumi
Publication year - 2017
Publication title -
journal of magnetic resonance imaging
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.563
H-Index - 160
eISSN - 1522-2586
pISSN - 1053-1807
DOI - 10.1002/jmri.25350
Subject(s) - medicine , magnetic resonance imaging , parenchyma , pathology , irradiation , liver cancer , liver tumor , cd68 , saline , liver parenchyma , nuclear medicine , radiation therapy , hepatocellular carcinoma , immunohistochemistry , radiology , physics , nuclear physics
Purpose To determine whether T2*‐weighted MRI has the ability to visualize the irradiated liver parenchyma and liver tumor after irradiation to the previously superparamagnetic iron oxide (SPIO)‐accumulated liver. Materials and Methods We examined 24 liver tumor‐bearing rats. Nine rats (Group 1) received 20 µmol Fe/kg SPIO and subsequent 70‐Gy irradiation to the tumor‐bearing liver lobe. Four rats (Group 2) received SPIO and sham irradiation. Six rats (Group 3) received saline and irradiation. Finally, five rats (Group 4) received saline and sham irradiation. We acquired sequential 3 Tesla T2*‐weighted images of the liver on day 7, and assessed MR image findings including signal intensity of the tumors and tumor‐bearing liver lobes. Results In six rats in Group 1, tumors shrunk by 39–100% (303–0 mm 3 ), and severely, well‐defined hypointense irradiated areas were observed. In the other two rats, tumors enlarged by 25 and 172% (595 and 1148 mm 3 ), and hypointense rings surrounded the tumors. The normalized relative signal intensity of the irradiated areas was significantly lower than that of the tumor (0.53 ± 0.06 versus 0.94 ± 0.06; P < 0.05). The severely, well‐defined hypointense areas were not observed in the other groups. Histologically, necrotic regions dominated and minimal nonnecrotic tumor cells remained in irradiated areas. The number of CD68‐positive cells was higher in irradiated areas than in nonirradiated areas. Conclusion T2*‐weighted MR imaging visualized the irradiated liver parenchyma as markedly, well‐defined hypointense areas and liver cancer lesions as hyperintense areas only when SPIO was administered before irradiation. The visualization of the hypointense area was associated with tumor regression after irradiation. Level of Evidence: 2 J. Magn. Reson. Imaging 2017;45:303–312.