Abstract
Purpose To test the hypothesis that biomarkers of fluorine 18 ((18)F) fluorodeoxyglucose (FDG) positron emission tomography (PET) can be used for the early detection of therapeutic response to irreversible electroporation (IRE) of liver tumor in a rodent liver tumor model. Materials and Methods The institutional animal care and use committee approved this study. Rats were inoculated with McA-RH7777 liver tumor cells in the left median and left lateral lobes. Tumors were allowed to grow for 7 days to reach a size typically at least 5 mm in longest diameter, as verified with magnetic resonance (MR) imaging. IRE electrodes were inserted, and eight 100-μsec, 2000-V pulses were applied to ablate the tumor tissue in the left median lobe. Tumor in the left lateral lobe served as a control in each animal. PET/computed tomography (CT) and MR imaging measurements were performed at baseline and 3 days after IRE for each animal. Additional MR imaging measurements were obtained 14 days after IRE. After 14-day follow-up MR imaging, rats were euthanized and tumors harvested for hematoxylin-eosin, CD34, and caspase-3 staining. Change in the maximum standardized uptake value (ΔSUV(max)) was calculated 3 days after IRE. The maximum lesion diameter change (ΔD(max)) was measured 14 days after IRE by using axial T2-weighted imaging. ΔSUV(max) and ΔD(max) were compared. The apoptosis index was calculated by using caspase-3-stained slices of apoptotic tumor cells. Pearson correlation coefficients were calculated to assess the relationship between ΔSUV(max) at 3 days and ΔD(max) (or apoptosis index) at 14 days after IRE treatment. Results ΔSUV(max,) ΔD(max), and apoptosis index significantly differed between treated and untreated tumors (P < .001 for all). In treated tumors, there was a strong correlation between ΔSUV(max) 3 days after IRE and ΔD(max) 14 days after IRE (R = 0.66, P = .01) and between ΔSUV(max) 3 days after IRE and apoptosis index 14 days after IRE (R = 0.57, P = .04). Conclusion (18)F-FDG PET imaging biomarkers can be used for the early detection of therapeutic response to IRE treatment of liver tumors in a rodent model. (©) RSNA, 2017.