Diagnostic value of dynamic contrast-enhanced CT with perfusion imaging in the quantitative assessment of tumor response to sorafenib in patients with advanced hepatocellular carcinoma: A feasibility study

Ippolito, Davide; Querques, Giulia; Okolicsanyi, S.; Franzesi, Cammillo Talei; Strazzabosco, Mario; Sironi, Sandro

doi:10.1016/j.ejrad.2017.02.027

Cited by 18 publications

(7 citation statements)

References 31 publications

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“…The curve fitting is achieved employing an in-house fitting algorithm based on the nonlinear, least squares, Levenberg-Marquardt minimization algorithm (lsqcurvefit, MATLAB © ; MathWorks, Natick, MA, USA). After TCCs computation, BF values, expressed in mL/min/100 g, were computed for AC and SCC subtypes using the maximum-slope method [ 32 , 33 ] by considering the first-pass phase only [ 34 ] and representing each voxel with a one-compartment model, including both the intravascular and the extravascular spaces [ 35 ]. This allowed performing short-time examinations with great benefits for patients, in terms of absorbed radiation dose and examination quality, since motion artefacts were reduced by the possibility for patients to hold their breath.…”

Section: Methodsmentioning

confidence: 99%

CT Perfusion in Patients with Lung Cancer: Squamous Cell Carcinoma and Adenocarcinoma Show a Different Blood Flow

Bevilacqua

Gavelli

Baiocco

et al. 2018

BioMed Research International

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Objectives To characterize tumour baseline blood flow (BF) in two lung cancer subtypes, adenocarcinoma (AC) and squamous cell carcinoma (SCC), also investigating those “borderline” cases whose perfusion value is closer to the group mean of the other histotype. Materials and Methods 26 patients (age range 36-81 years) with primary Non-Small Cell Lung Cancer (NSCLC), subdivided into 19 AC and 7 SCC, were enrolled in this study and underwent a CT perfusion, at diagnosis. BF values were computed according to the maximum-slope method and unreliable values (e.g., arising from artefacts or vessels) were automatically removed. The one-tail Welch's t-test (p-value <0.05) was employed for statistical assessment. Results At diagnosis, mean BF values (in [mL/min/100g]) of AC group [(83.5 ± 29.4)] are significantly greater than those of SCC subtype [(57.0 ± 27.2)] (p-value = 0.02). However, two central SCCs undergoing artefacts from vena cava and pulmonary artery have an artificially increased mean BF. Conclusions The different hemodynamic behaviour of AC and SCC should be considered as a biomarker supporting treatment planning to select the patients, mainly with AC, that would most benefit from antiangiogenic therapies. The significance of results was achieved by automatically detecting and excluding artefactual BF values.

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Section: Methodsmentioning

confidence: 99%

CT Perfusion in Patients with Lung Cancer: Squamous Cell Carcinoma and Adenocarcinoma Show a Different Blood Flow

Bevilacqua

Gavelli

Baiocco

et al. 2018

BioMed Research International

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“…Time to peak (TTP) is defined as the time to reach the maximum value of contrast material concentration (26). Recently, TTP has been proved to be a surrogate parameter to increase the quantitative accuracy of CT perfusion imaging in animal models of bronchial occlusion (27).…”

Section: Discussionmentioning

confidence: 99%

Pulmonary Dual Hemodynamic Changes in Severe COPD Patients: A Quantitative Study Using Low-Dose CT Lung Perfusion Scan

Jin

Liang

et al. 2018

Iran J Radiol

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Background: Computed tomography (CT) lung perfusion scan could be used to evaluate regional, morphologic, and functional changes in chronic obstructive pulmonary disease (COPD) noninvasively. However, the dual hemodynamic changes in severe COPD patients have not been studied quantitatively using CT lung perfusion scan. Objectives: To determine the dual hemodynamic changes quantitatively in patients with severe COPD by using low-dose CT lung perfusion scan. Patients and Methods: Fifteen patients with severe COPD (global initiative for chronic obstructive lung disease [GOLD] class IV) and 31 controls were enrolled. All participants received low-dose CT lung perfusion scan using a Toshiba 320-detector row dynamic volumetric CT. The perfusion parameters including pulmonary artery flow (PAF), bronchial artery flow (BAF), perfusion index [PI = PAF/(PAF + BAF)] and time to peak (TTP) of the time density curve were generated and compared between the impaired lung parenchyma in the COPD group and normal lung parenchyma in the control group. Results: The PAF and PI values in the COPD group were significantly lower than that in the control group (P < 0.001, P < 0.001), while the BAF value was significantly higher (P < 0.001). The TTP of impaired lung parenchyma was significantly prolonged compared to the normal lung parenchyma (P < 0.001). Conclusion: Patients with severe COPD have distinct changes in pulmonary dual hemodynamics. Low-dose lung perfusion scan using a 320-detector row dynamic volumetric CT could be used to evaluate the pulmonary dual hemodynamics.

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“… 34 Studies have also investigated changes in tumour perfusion following treatment with systemic therapy. 35 , 36 The identification of such biomarkers, that represent areas at risk of radio-resistance, may therefore highlight areas within the tumour that may require focal dose escalation.…”

Section: Advances In Ct Imagingmentioning

confidence: 99%

How rapid advances in imaging are defining the future of precision radiation oncology

et al. 2019

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Imaging has an essential role in the planning and delivery of radiotherapy. Recent advances in imaging have led to the development of advanced radiotherapy techniques-including image-guided radiotherapy, intensity-modulated radiotherapy, stereotactic body radiotherapy and proton beam therapy. The optimal use of imaging might enable higher doses of radiation to be delivered to the tumour, while sparing normal surrounding tissues. In this article, we review how the integration of existing and novel forms of computed tomography, magnetic resonance imaging and positron emission tomography have transformed tumour delineation in the radiotherapy planning process, and how these advances have the potential to allow a more individualised approach to the cancer therapy. Recent data suggest that imaging biomarkers that assess underlying tumour heterogeneity can identify areas within a tumour that are at higher risk of radio-resistance, and therefore potentially allow for biologically focussed dose escalation. The rapidly evolving concept of adaptive radiotherapy, including artificial intelligence, requires imaging during treatment to be used to modify radiotherapy on a daily basis. These advances have the potential to improve clinical outcomes and reduce radiation-related long-term toxicities. We outline how recent technological advances in both imaging and radiotherapy delivery can be combined to shape the future of precision radiation oncology.

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Diagnostic value of dynamic contrast-enhanced CT with perfusion imaging in the quantitative assessment of tumor response to sorafenib in patients with advanced hepatocellular carcinoma: A feasibility study

Cited by 18 publications

References 31 publications

CT Perfusion in Patients with Lung Cancer: Squamous Cell Carcinoma and Adenocarcinoma Show a Different Blood Flow

CT Perfusion in Patients with Lung Cancer: Squamous Cell Carcinoma and Adenocarcinoma Show a Different Blood Flow

Pulmonary Dual Hemodynamic Changes in Severe COPD Patients: A Quantitative Study Using Low-Dose CT Lung Perfusion Scan

How rapid advances in imaging are defining the future of precision radiation oncology

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