Gurevich Alexey, Islam Ariful, Wakim Jonathan, Yarsky Eva, Kiefer Ryan, El-Ghazal Ryan, McClung George, Cormode David P, Nadolski Gregory J, Avritscher Rony, Hunt Stephen J, Gade Terence P F
Penn Image-Guided Interventions Laboratory, Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania.
Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania.
J Vasc Interv Radiol. 2025 Apr;36(4):670-678.e2. doi: 10.1016/j.jvir.2024.12.004. Epub 2024 Dec 10.
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).
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.
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).
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.
基于肝细胞癌（HCC）转化大鼠模型的影像学和组织学反应，比较使用液体栓塞剂（LE）的经动脉栓塞术（TAE）与使用颗粒栓塞剂（PE）的TAE的有效性。
使用二乙基亚硝胺在Wistar大鼠中诱导HCC。通过应用于T2加权磁共振（MR）成像扫描的实体瘤疗效评价标准来确定肿瘤反应。分别通过苏木精和伊红染色以及匹莫硝唑染色评估肿瘤坏死和缺氧情况。使用卡方检验、Kaplan-Meier估计、逻辑回归和单因素方差分析进行统计分析，显著性设定为P <.05。
29只大鼠被随机分为接受LE的TAE组（n = 13）、PE的TAE组（n = 13）或假手术组（n = 3）。与PE的TAE（28%；χ = 11.25；P =.0008）相比，LE的TAE显示出显著更高的客观缓解率（83%）。在接受LE治疗的肿瘤中，50%观察到完全缓解，而在接受PE治疗的组中为10%。LE的TAE延长了局部无进展生存期（风险比，0.31；P =.032）。对另外16只随机分为接受LE的TAE组（n = 7）、PE的TAE组（n = 6）或假手术组（n = 3）的大鼠进行组织学分析，结果显示与接受PE治疗的肿瘤相比，接受LE治疗的肿瘤坏死更严重。与PE相比，LE诱导的存活肿瘤组织减少显著更多（P =.009），坏死和坏死 + 缺氧组织区域比例更大（P =.003）。
与PE相比，LE在HCC大鼠模型中显著增强了TAE的治疗效果。这些结果突出了LE改善缺血和坏死的潜力，从而为提高HCC治疗的栓塞效果提供了一个有前景的选择。
