Early perfusion changes within 1 week of systemic treatment measured by dynamic contrast-enhanced MRI may predict survival in patients with advanced hepatocellular carcinoma

Chen, Bang-Bin; Hsu, Chien‐Tien; Yu, Chih‐Wei; Liang, Po-Chin; Hsu, Chiun; Hsu, Chih‐Hung; Cheng, Ann‐Lii; Shih, Tiffany Ting-Fang

doi:10.1007/s00330-016-4670-2

Cited by 19 publications

(27 citation statements)

References 43 publications

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“…The mRECIST criteria have been applied to overcome this limitation, but its measurements are subjective and not always easy to reproduce on longitudinal follow-up studies. There has been an interest in the use of p-MRI techniques in advanced HCC, which allows monitoring the response to therapy at an early stage of treatment [6, 8]. Furthermore, this technique provides quantitative evaluation of tumor vascular modifications after treatment [2, 6, 11, 16].…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, this technique provides quantitative evaluation of tumor vascular modifications after treatment [2, 6, 11, 16]. One of the parameters obtained by the p-MRI is ktrans, which determines the flow of contrast from the intravascular space to the extracellular space that may indicate a change in tumor blood flow or vascular permeability [8, 11, 19, 23]. …”

Section: Discussionmentioning

confidence: 99%

“…Between 70 and 90% of the HCC cases occur in patients with chronic liver disease and cirrhosis [4, 5]. Most HCC patients show advanced disease at the time of diagnosis, given the scarcity of specific symptoms in the early stages, which causes a worse prognosis [2, 5-8]. …”

Section: Introductionmentioning

confidence: 99%

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Perfusion Magnetic Resonance as a Biomarker for Sorafenib-Treated Advanced Hepatocellular Carcinoma: A Pilot Study

Campos

Candelária

Papanikolaou

et al. 2019

GE Port J Gastroenterol

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Background: Sorafenib is the currently recommended therapy in patients with advanced hepatocellular carcinoma (HCC). Among the several biomarkers available for the evaluation of the therapeutic response and prognosis, there is perfusion magnetic resonance imaging (p-MRI) that, through measurement of the vascular permeability unit (ktrans), may retrieve useful information regarding the microvascular properties of focal liver lesions. The aim of this study was to evaluate the impact of sorafenib therapy in patients with advanced HCC using the p-MRI technique. Materials and Methods: In this retrospective study, 27 patients with the diagnosis of advanced HCC were included for palliative therapy using sorafenib. MRI of the liver was performed before the beginning of the oral therapy (T0), after 3 (T3), and after 6 months (T6). Dynamic acquisitions of the tumor (n = 50, during the first 2 min after contrast injection) were obtained in the coronal plane and were used to compute the parametric perfusion maps, acquiring the ktrans value using the extended Tofts pharmacokinetic model. Results: The value of ktrans obtained at T0 was significantly different from the value of ktrans obtained at T6 (p = 0.028). There were no significant differences between T0 and T3 (p = 0.115) or a correlation between ktrans at T0 and the size of the lesion (p = 0.376). The ktrans value at T0 in patients with progression-free survival (PFS) > 6 months was not significantly different from the ktrans value in patients with PFS ≤6 months (p = 0.113). The ktrans value at T0 was not significantly different between patients who were previously submitted to chemoembolization and those who were not submitted (p = 0.587). Conclusion: In this pilot study, the ktrans value may serve as a biomarker of tumor response to antiangiogenic therapy, but only 6 months after its initiation. Clinical outcomes such as PFS were not predicted before the initiation of treatment.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Perfusion Magnetic Resonance as a Biomarker for Sorafenib-Treated Advanced Hepatocellular Carcinoma: A Pilot Study

Campos

Candelária

Papanikolaou

et al. 2019

GE Port J Gastroenterol

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“…In oncological imaging, simultaneous acquisition affords precise information regarding organ movement, resulting in better matching of the lesions identified on MRI and PET, and improvements in the accuracy of SUV calculations . This allows physicians to perform multiparametric evaluation in oncology treatment, to monitor therapy response, and to observe treatment efficacy—sometimes in as little as 1 week—without having to wait several months to see tumor response on CT images …”

Section: Discussionmentioning

confidence: 99%

“…25 This allows physicians to perform multiparametric evaluation in oncology treatment, to monitor therapy response, and to observe treatment efficacy-sometimes in as little as 1 week-without having to wait several months to see tumor response on CT images. 30 FIGURE 4: Disease-free survival in 17 patients with NSCLC with disease limited to the lung who were receiving SBRT as primary treatment. Initial high SUV max (>10) tended to correlate with disease progression, although the result was not statistically significant (P 5 0.083).…”

Section: Discussionmentioning

confidence: 99%

Response assessment of stereotactic body radiation therapy using dynamic contrast‐enhanced integrated MR‐PET in non‐small cell lung cancer patients

Huang

Chen

Hsu

et al. 2017

Magnetic Resonance Imaging

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Purpose: To evaluate the response in patients undergoing SBRT using dynamic contrast-enhanced (DCE) integrated magnetic resonance positron emission tomography (MR-PET). Stereotactic body radiation therapy (SBRT) is efficacious as a front-line local treatment for non-small cell lung cancer (NSCLC). Materials and Methods: We prospectively enrolled 19 lung tumors in 17 nonmetastatic NSCLC patients who were receiving SBRT as a primary treatment. They underwent DCE-integrated 3T MR-PET before and 6 weeks after SBRT. The following image parameters were analyzed: tumor size, standardized uptake value (SUV), apparent diffusion coefficient, K trans , k ep , v e , v p , and iAUC 60 . Chest computed tomography (CT) was performed at 3 months after SBRT. Results: SBRT treatment led to tumor changes including significant decreases in the SUV max (-61%, P < 0.001), K trans mean (-72%, P 5 0.005), K trans standard deviation (SD; -85%, P 5 0.046), k ep mean (-53%, P 5 0.014), k ep SD (-63%, P 5 0.001), and v p SD (-58%, P 5 0.002). The PET SUV max was correlated with the MR k ep mean (P 5 0.002) and k ep SD (P < 0.001). The percentage reduction in K trans mean (P < 0.001) and k ep mean (P 5 0.034) at 6 weeks post-SBRT were significantly correlated with the percentage reduction in tumor size, as measured using CT at 3 months after SBRT. Univariate analyses revealed a trend toward disease progression when the initial SUV max > 10 (P 5 0.083). Conclusion: In patients with NSCLC who are receiving SBRT, DCE-integrated MR-PET can be used to evaluate the response after SBRT and to predict the local treatment outcome. Level of Evidence: 2 Technical Efficacy: Stage 1 J. MAGN. RESON. IMAGING 2018;47:191-199. S tereotactic body radiotherapy (SBRT) is a standard treatment option for patients with stage I non-small cell lung cancer (NSCLC), who are not candidates for surgery.1 Nonrandomized, single-institution, and population-based studies have reported that the clinical outcomes of SBRT are comparable with those of primary surgery, with local control rates of over 90%.2 Furthermore, SBRT offers superior outcomes, lower costs, and greater patient convenience than conventional radiation therapy. 3To evaluate treatment response in cases of lung cancer, researchers commonly use the Response Evaluation Criteria View this article online at wileyonlinelibrary.com.

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Can dual-energy CT replace perfusion CT for the functional evaluation of advanced hepatocellular carcinoma?

Mulé

Pigneur

Quelever³

et al. 2017

Eur Radiol

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Early perfusion changes within 1 week of systemic treatment measured by dynamic contrast-enhanced MRI may predict survival in patients with advanced hepatocellular carcinoma

Abstract: • DCE-MRI is helpful to evaluate perfusion changes of HCC after systemic treatment. • Early perfusion changes within 1 week after treatment may predict overall survival. • High Peak reduction was an independent favourable prognostic factor after systemic treatment.

Cited by 19 publications

References 43 publications

Perfusion Magnetic Resonance as a Biomarker for Sorafenib-Treated Advanced Hepatocellular Carcinoma: A Pilot Study

Perfusion Magnetic Resonance as a Biomarker for Sorafenib-Treated Advanced Hepatocellular Carcinoma: A Pilot Study

Response assessment of stereotactic body radiation therapy using dynamic contrast‐enhanced integrated MR‐PET in non‐small cell lung cancer patients

Can dual-energy CT replace perfusion CT for the functional evaluation of advanced hepatocellular carcinoma?

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