“Our analysis shows how to clearly define and demarcate between patients whose tumors are responding to treatment and those who are not,” says Kamel. This is very important, he adds, because in islet cell carcinoma, some patients’ cancer symptoms, such as headaches, ulcers, pain and diarrhea, can be masked by the liver’s hormone production. The disappearance or absence of symptoms is not a reliable indicator of treatment success.
Larger studies already planned will measure how well the apparent diffusion coefficients for each kind of combination chemotherapy predict survival and how much time remains to switch treatment plans.
In transcatheter arterial chemoembolization, interventional radiologists thread an ultrathin catheter through an abdominal artery directly to the main arteries feeding the liver tumor. Drug-eluting beads are delivered to and released directly inside the tumor to kill it by cutting off its blood supply. The roughly half-hour procedure carries a slight risk of bleeding or damage to the blood vessels, while the toxic drug treatment can permanently damage otherwise healthy liver tissue. Most patients are discharged from the hospital within a day, and many are able to resume physical activity and work.
The Cholangiocarcinoma Foundation estimates that some 2,500 people are newly diagnosed each year with the bile duct cancer, most in the moderate to advanced stages of disease.
Studies have estimated that islet cell carcinomas account for at least 1.3 percent of the 44,000 new cases of pancreatic cancer in the United States each year.
Funding support for both studies was provided by Siemens Healthcare, of Princeton, N.J., the manufacturer of the MRI scanners used in the study.
Other Hopkins researchers, besides Kamel, involved in these studies were Vivek Gowdra Halappa, M.D.; Susanne Bonekamp, D.V.M., Ph.D.; Celia Corona-Villalobos; Li, Zhen; Margaret Mensa, B.S.N.; Diane Reyes; John Eng, M.D.; Timothy Pawlik, M.D., M.P.H.; Nikhil Bhagat, M.D.; Hong Lai, Ph.D., M.P.H.; and Jean-Francois Geschwind, M.D.
For additional information, go to: http://www.hopkinsradiology.org/MRI/Faculty/Kamel