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Liver Metastases in Rats: Chemoembolization Combined with Interstitial Laser Ablation for Treatment¹

¹ From the Institute for Diagnostic and Interventional Radiology (A.M., J.Q., M.G.M., M.F.K., M.R., S.S., T.J.V.) and Department of Visceral Surgery (E.O., W.O.B.), Johann Wolfgang Goethe University, Theodor-Stern-Kai 7, 60590 Frankfurt, Germany. Received August 30, 2004; revision requested October 29; revision received December 23; accepted January 24, 2005. Address correspondence to A.M. (e-mail: adel.maataoui{at}gmx.de).

View larger version (179K): [in a new window]   Figure 1. Catheterization and TACE performed in vivo in a rat. A polyethylene catheter was retrogradely inserted into the gastroduodenal artery (curved arrow) and pushed forward to the common hepatic artery. After the prepared silk suture was slightly drawn around the common hepatic artery (arrowhead), mitomycin, iodized oil, and degradable starch microspheres were slowly injected. Straight arrow points to proper hepatic artery.

View larger version (123K): [in a new window]   Figure 2. LITT performed in vivo in a rat. An Nd:YAG laser with a wavelength of 1064 nm was applied to the tissue by using a diffusing applicator (outer diameter of 0.8 mm, active length of 5.0 mm). The applicator was inserted along the longest diameter of the tumor in its center at a depth of about 0.5 cm. Laser application time was 5 minutes. At this wavelength, the laser light energy (power of 2 W) penetrated deeply into the tissue, where photon absorption and heat conduction produced coagulative and hyperthermic effects.

View larger version (103K): [in a new window]   Figure 3a. Transverse MR images of solid liver metastasis in a group A (TACE alone) WAG rat. (a) Pretreatment unenhanced T1-weighted spin-echo MR image (460/15) shows a small hypointense tumor (arrow) in the left lateral liver lobe. (b) On the pretreatment unenhanced T2-weighted turbo spin-echo MR image (3170/99), the lesion in a is seen as a hyperintense 0.66 x 0.58-cm tumor (arrow) that is well discernible from the surrounding liver tissue. (c) On the posttreatment unenhanced T1-weighted spin-echo MR image (460/15), the same lesion is a relatively large hypointense tumor (arrow) in the left lateral liver lobe and is accompanied by a small subcapsular hypointense tumor. (d) On the posttreatment unenhanced T2-weighted spin-echo MR image (3170/17), the same lesion appears as a 1.14 x 1.05-cm tumor (arrow) with relatively rapid growth compared with its growth before therapy. A small subcapsular hyperintense area corresponding to the intrahepatic metastasis also is seen.

View larger version (110K): [in a new window]   Figure 3b. Transverse MR images of solid liver metastasis in a group A (TACE alone) WAG rat. (a) Pretreatment unenhanced T1-weighted spin-echo MR image (460/15) shows a small hypointense tumor (arrow) in the left lateral liver lobe. (b) On the pretreatment unenhanced T2-weighted turbo spin-echo MR image (3170/99), the lesion in a is seen as a hyperintense 0.66 x 0.58-cm tumor (arrow) that is well discernible from the surrounding liver tissue. (c) On the posttreatment unenhanced T1-weighted spin-echo MR image (460/15), the same lesion is a relatively large hypointense tumor (arrow) in the left lateral liver lobe and is accompanied by a small subcapsular hypointense tumor. (d) On the posttreatment unenhanced T2-weighted spin-echo MR image (3170/17), the same lesion appears as a 1.14 x 1.05-cm tumor (arrow) with relatively rapid growth compared with its growth before therapy. A small subcapsular hyperintense area corresponding to the intrahepatic metastasis also is seen.

View larger version (126K): [in a new window]   Figure 3c. Transverse MR images of solid liver metastasis in a group A (TACE alone) WAG rat. (a) Pretreatment unenhanced T1-weighted spin-echo MR image (460/15) shows a small hypointense tumor (arrow) in the left lateral liver lobe. (b) On the pretreatment unenhanced T2-weighted turbo spin-echo MR image (3170/99), the lesion in a is seen as a hyperintense 0.66 x 0.58-cm tumor (arrow) that is well discernible from the surrounding liver tissue. (c) On the posttreatment unenhanced T1-weighted spin-echo MR image (460/15), the same lesion is a relatively large hypointense tumor (arrow) in the left lateral liver lobe and is accompanied by a small subcapsular hypointense tumor. (d) On the posttreatment unenhanced T2-weighted spin-echo MR image (3170/17), the same lesion appears as a 1.14 x 1.05-cm tumor (arrow) with relatively rapid growth compared with its growth before therapy. A small subcapsular hyperintense area corresponding to the intrahepatic metastasis also is seen.

View larger version (117K): [in a new window]   Figure 3d. Transverse MR images of solid liver metastasis in a group A (TACE alone) WAG rat. (a) Pretreatment unenhanced T1-weighted spin-echo MR image (460/15) shows a small hypointense tumor (arrow) in the left lateral liver lobe. (b) On the pretreatment unenhanced T2-weighted turbo spin-echo MR image (3170/99), the lesion in a is seen as a hyperintense 0.66 x 0.58-cm tumor (arrow) that is well discernible from the surrounding liver tissue. (c) On the posttreatment unenhanced T1-weighted spin-echo MR image (460/15), the same lesion is a relatively large hypointense tumor (arrow) in the left lateral liver lobe and is accompanied by a small subcapsular hypointense tumor. (d) On the posttreatment unenhanced T2-weighted spin-echo MR image (3170/17), the same lesion appears as a 1.14 x 1.05-cm tumor (arrow) with relatively rapid growth compared with its growth before therapy. A small subcapsular hyperintense area corresponding to the intrahepatic metastasis also is seen.

View larger version (102K): [in a new window]   Figure 4a. Transverse MR images of solid liver metastasis (arrow) in a group B (LITT alone) WAG rat. (a) Posttreatment unenhanced T1-weighted spin-echo MR image (460/15) shows a hypointense tumor with a hyperintense intratumoral focus in the left lateral liver lobe. (b) On the posttreatment unenhanced T2-weighted turbo spin-echo MR image (3170/99), the same tumor (1.25 x 1.08 cm) is hyperintense and has a central hypointense area corresponding to intratumoral coagulation. No intrahepatic metastasis was observed.

View larger version (112K): [in a new window]   Figure 4b. Transverse MR images of solid liver metastasis (arrow) in a group B (LITT alone) WAG rat. (a) Posttreatment unenhanced T1-weighted spin-echo MR image (460/15) shows a hypointense tumor with a hyperintense intratumoral focus in the left lateral liver lobe. (b) On the posttreatment unenhanced T2-weighted turbo spin-echo MR image (3170/99), the same tumor (1.25 x 1.08 cm) is hyperintense and has a central hypointense area corresponding to intratumoral coagulation. No intrahepatic metastasis was observed.

View larger version (131K): [in a new window]   Figure 5. Transverse posttreatment unenhanced T2-weighted turbo spin-echo MR image (3170/99) of a solid liver metastasis (arrow) in a group C (TACE plus LITT) WAG rat. Image shows a 0.92 x 0.89-cm hyperintense tumor with a central hypointense area corresponding to intratumoral coagulation. No intrahepatic metastasis was observed. The smaller size of this tumor, compared with the sizes of the tumors in rat groups A and B, indicates the absence of marked tumor growth after therapy compared with the tumor growth before therapy.