Comparison of Liquid with Particle Embolics in a Translational Rat Model of Hepatocellular Carcinoma: Histologic and Radiographic Responses.

PURPOSE

To compare the effectiveness of transarterial embolization (TAE) using a liquid embolic (LE) with that of TAE using a particle embolic (PE) based on radiographic and histologic responses in a translational rat model of hepatocellular carcinoma (HCC).

MATERIALS AND METHODS

HCC was induced in Wistar rats using diethylnitrosamine. Tumor response was determined through Response Evaluation Criteria in Solid Tumors applied to T2-weighted magnetic resonance (MR) imaging scans. Tumor necrosis and hypoxia were assessed through hematoxylin and eosin and pimonidazole staining, respectively. Statistical analyses were performed using chi-square tests, Kaplan-Meier estimates, logistic regression, and 1-way analysis of variance, with significance set at P < .05.

RESULTS

Twenty-nine rats were randomized to TAE with LE (n = 13), PE (n = 13), or sham (n = 3). LE TAE demonstrated a significantly higher objective response rate (83%) compared with PE TAE (28%; χ = 11.25; P = .0008). Complete responses were observed in 50% of the LE-treated tumors versus 10% in the PE-treated group. LE TAE prolonged local progression-free survival (hazard ratio, 0.31; P = .032). Histologic analysis of an additional 16 rats randomized to TAE with LE (n = 7), PE (n = 6), or sham (n = 3) showed greater necrosis in LE-treated tumors compared to PE-treated tumors. LE induced a significantly greater reduction in viable tumor tissue (P = .009) and proportionally larger necrotic and necrotic + hypoxic tissue areas compared with PE (P = .003).

CONCLUSIONS

LE significantly enhanced the therapeutic effectiveness of TAE in a rat model of HCC compared with PE. These results highlight the potential of LEs to improve ischemia and necrosis, thereby offering a promising option for improving the effectiveness of embolization for HCC treatment.