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Last Updated: 09/21/17
Quantitative Imaging Network (QIN)

Mount Sinai — Icahn School of Medicine

Evaluation of HCC Response to Systemic Therapy with Quantitative MRI

Bachir Taouli, MD
Grant Number: U01 CA172320

Dr. Taouli’s team has optimized and developed a multiparametric MRI protocol (Specific Aim 1) quantifying different features of hepatocellular carcinoma (HCC) tumor biology and pathology, including tumor cellularity, grade, angiogenesis and degree of hypoxia. The multiparametric MRI (mpMRI) approach includes intravoxel incoherent motion (IVIM) DWI, DCE-MRI, T2* and T1 mapping using oxygen and carbogen challenge.

This protocol has been performed in patients with HCC, including patients undergoing hepatic resection. Routine and advanced histopathologic methods have been performed in a subset of patients (Specific Aim 2). Initial studies in thirty patients, the team demonstrated that the R1 and R2* parameters in HCC are reproducible, and that there is a statistically significant decrease in R2* values in HCC before and after O2, and increase in R1 after O2. No significant effect was observed with carbogen.

In addition, the team assessed correlations between IVIM-DWI and DCE-MRI in HCC tumors and liver parenchyma. DCE-MRI derived arterial fraction and arterial flow were significantly negatively correlated with IVIM-DWI-derived perfusion fraction and pseudodiffusion in the liver, while IVIM-DWI parameters did not correlate with DCE-MRI parameters in HCC. These results indicate that IVIM-DWI and DCE-MRI provide non-redundant information in HCC.

Recently, Dr. Taouli’s group assessed intratumor heterogeneity in HCC using mpMRI and histogram quantification (central tendency parameters mean and median and heterogeneity parameters standard deviation, kurtosis and skewness) in HCC lesions. The imaging findings were correlated with histopathology and gene expression levels. The team observed that central tendency and heterogeneity parameters were largely complementary in terms of the assessed correlations. The proposed histogram analysis is therefore promising for noninvasive HCC characterization on the functional, immunohistochemical and genomics level.

Lastly, the team is currently acquiring data assessing the prediction of HCC response to yttrium 90 radioembolization in unresectable HCC (Specific Aim 3).


  1. Bane O, Besa C, Wagner M, Oesingmann N, Zhu H, Fiel MI, Taouli B. Feasibility and reproducibility of BOLD and TOLD measurements in the liver with oxygen and carbogen gas challenge in healthy volunteers and patients with hepatocellular carcinoma. J Magn Reson Imaging. 2016 Apr;43(4):866-76. PubMed PMID: 26417669; PubMed Central PMCID: PMC4803537.

  2. Hectors SJ, Wagner M, Besa C, Bane O, Dyvorne HA, Fiel MI, Zhu H, Donovan M, Taouli B. Intravoxel incoherent motion diffusion-weighted imaging of hepatocellular carcinoma: Is there a correlation with flow and perfusion metrics obtained with dynamic contrast-enhanced MRI? Journal of magnetic resonance imaging : JMRI. 2016;44(4):856-64. doi: 10.1002/jmri.25194. PubMed PMID: 26919327; PMCID: 5142524.

  3. Hectors SJ, Wagner M, Bane O, Besa C, Lewis S, Remark R, Chen N, Fiel MI, Zhu H, Gnjatic S, Merad M, Hoshida Y, Taouli B. Quantification of hepatocellular carcinoma heterogeneity with multiparametric magnetic resonance imaging. Scientific reports. 2017;7(1):2452. doi: 10.1038/s41598-017-02706-z. PubMed PMID: 28550313; PMCID: 5446396.

  4. Jajamovich GH, Huang W, Besa C, Li X, Afzal A, Dyvorne HA, Taouli B. DCE-MRI of hepatocellular carcinoma: perfusion quantification with Tofts model versus shutter-speed model--initial experience. Magma. 2016;29(1):49-58. doi: 10.1007/s10334-015-0513-4. PubMed PMID: 26646522; PMCID: 5175209.

  5. Bane O, Hectors S, Wagner M, Arlinghaus L, Aryal M, Cao Y, Chenevert T, Fennessy F, Huang W, Hylton N, Kalpathy-Cramer J, Keenan K, Malyarenki D, Mulkern R, Newitt D, Russek S, Stupic K, Tudorica A, Wilmes L, Yankeelov T, Yen Y, Boss M, Taouli B. Accuracy, repeatability and interplatform reproducibility of T1 quantification methods used for DCE-MRI: results from a multicenter phantom study. Magn Reson Med (accepted for publication).

Mount Sinai — Icahn School of Medicine Team

Taouli’s Lab URL: