Joseph Ralph Kallini1, Frank H Miller2, Ahmed Gabr1, Riad Salem1,3,4, Robert J Lewandowski5. 1. Department of Radiology, Section of Interventional Radiology, Northwestern Memorial Hospital, Robert H. Lurie Comprehensive Cancer Center, 676 N. St. Clair, Suite 800, Chicago, IL, USA. 2. Department of Radiology, Northwestern University Feinberg School of Medicine, Northwestern Memorial Hospital, 676 North Saint Clair Street, Suite 800, Chicago, IL, 60611, USA. 3. Department of Surgery, Division of Transplantation, Comprehensive Transplant Center, Northwestern University, Chicago, IL, USA. 4. Department of Medicine, Division of Hematology and Oncology, Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, IL, USA. 5. Department of Radiology, Section of Interventional Radiology, Northwestern Memorial Hospital, Robert H. Lurie Comprehensive Cancer Center, 676 N. St. Clair, Suite 800, Chicago, IL, USA. r-lewandowski@northwestern.edu.
Abstract
PURPOSE: To discuss guidelines and salient imaging findings of solid tumors treated with common intra-arterial procedures used in interventional oncology. METHODS: A meticulous literature search of PubMed-indexed articles was conducted. Key words included "imaging + embolization," "imaging + TACE," "imaging + radioembolization," "imaging + Y90," "mRECIST," and "EASL." Representative post-treatment cross-sectional images were obtained from past cases in this institution. RESULTS: Intra-arterial therapy (IAT) in interventional oncology includes bland embolization, chemoembolization, and radioembolization. Solid tumors of the liver are the primary focus of these procedures. Cross-sectional CT and/or MR are the main modalities used to image tumors after treatment. Traditional size-based response criteria (WHO and RECIST) alone are of limited utility in determining response to IAT; tumoral necrosis and enhancement must be considered. Specifically for HCC, the EASL and mRECIST guidelines are becoming widely adopted response criteria to assess these factors. DWI, FDG-PET, and CEUS are modalities that play an adjunctive but controversial role. CONCLUSIONS: Radiologists must be aware that the different forms of intra-arterial therapy yield characteristic findings on cross-sectional imaging. Knowledge of these findings is integral to accurate assessment of tumor response and progression.
PURPOSE: To discuss guidelines and salient imaging findings of solid tumors treated with common intra-arterial procedures used in interventional oncology. METHODS: A meticulous literature search of PubMed-indexed articles was conducted. Key words included "imaging + embolization," "imaging + TACE," "imaging + radioembolization," "imaging + Y90," "mRECIST," and "EASL." Representative post-treatment cross-sectional images were obtained from past cases in this institution. RESULTS: Intra-arterial therapy (IAT) in interventional oncology includes bland embolization, chemoembolization, and radioembolization. Solid tumors of the liver are the primary focus of these procedures. Cross-sectional CT and/or MR are the main modalities used to image tumors after treatment. Traditional size-based response criteria (WHO and RECIST) alone are of limited utility in determining response to IAT; tumoral necrosis and enhancement must be considered. Specifically for HCC, the EASL and mRECIST guidelines are becoming widely adopted response criteria to assess these factors. DWI, FDG-PET, and CEUS are modalities that play an adjunctive but controversial role. CONCLUSIONS: Radiologists must be aware that the different forms of intra-arterial therapy yield characteristic findings on cross-sectional imaging. Knowledge of these findings is integral to accurate assessment of tumor response and progression.
Authors: Ania Kielar; Kathryn J Fowler; Sara Lewis; Vahid Yaghmai; Frank H Miller; Hooman Yarmohammadi; Charles Kim; Victoria Chernyak; Takeshi Yokoo; Jeffrey Meyer; Isabel Newton; Richard K Do Journal: Abdom Radiol (NY) Date: 2018-01
Authors: Rehan Ali; Ahsun Riaz; Ahmed Gabr; Nadine Abouchaleh; Ronald Mora; Ali Al Asadi; Juan Carlos Caicedo; Michael Abecassis; Nitin Katariya; Haripriya Maddur; Laura Kulik; Robert J Lewandowski; Riad Salem Journal: Eur J Nucl Med Mol Imaging Date: 2017-08-15 Impact factor: 9.236
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Authors: William T N Culp; Eric G Johnson; Michelle A Giuffrida; Robert B Rebhun; James K Cawthra; Heidi A Schwanz; Jenna H Burton; Michael S Kent Journal: PLoS One Date: 2022-08-08 Impact factor: 3.752